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Expungement Petition

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					  IN THE ___________________________________ JUDICIAL DISTRICT
      DISTRICT COURT, __________________ COUNTY, KANSAS
                    CRIMINAL DEPARTMENT
___________________________, )
                   Petitioner,)
vs.                           )
                                                Case No.
                              )
THE STATE OF KANSAS,          )
                 Respondent. )

         PETITION FOR EXPUNGEMENT OF ARREST RECORD

       COMES NOW the defendant in the above-captioned matter and petitions

the Court for an Expungment of his criminal record pursuant to K.S.A.22-2410. In

support of this petition, defendant alleges and states:

       1. That petitioner, _____________________, is a _______ (race) _______

       (sex), with a date of birth of XX/XX/19____; (Only list the year you were

       born.)

       2. That defendant was arrested on __________________________ by

       _______________________under the name of____________________

       for the crime of _________________________________;

       3. CHOOSE ONE OF THE FOLLOWING:

                a. That the arrest occurred because of mistaken identity;.

                       OR

                b. A Court found there was no probable cause for the arrest;

                       OR

                c. The petitioner was found not guilty in court proceedings;

                       OR
              d. The expungment would be in the best interests of justice and

       charges have been dismissed or no charges are likely to be filed;.

       4. The defendant's current circumstances and behavior warrant this

       expungment and this expungment is consistent with public welfare.




                        VERIFICATION
STATE OF KANSAS       )
                      ) ss:
______________ COUNTY )

        __________________________________________, of lawful age, being
first duly sworn upon his oath, states:

That I am the Petitioner in the above and foregoing action, that I have read the
foregoing Petition for Expungment and that the statements contained therein are
true and correct.

       ______________________
       Defendant

       SUBSCRIBED AND SWORN to before me, a Notary Public, on this
       ______day of , 20__ .


                                                    ________________________

       My Commission Expires:
                         CERTIFICATE OF SERVICE
       I HEREBY CERTIFY that a true and correct copy of the above and
foregoing Petition for Expungment was mailed, postage prepaid and properly
addressed, this day of ,
20____, to ________________, Assistant District Attorney,
______________________________ County Courthouse, [ADDRESS OF
COURTHOUSE]
DISTRICT COURT, _____________________________ COUNTY, KANSAS
                  CRIMINAL DEPARTMENT

___________________________, )
                   Petitioner,)
vs.                           )
                                                            Case No.
                          )
THE STATE OF KANSAS,      )
              Respondent. )


                                     AFFIDAVIT

STATE OF KANSAS       )
                      ) ss:
______________ COUNTY )

       ___________________________________, of lawful age, being first duly

sworn on oath, alleges and states:

       1. That he/she is the petitioner in the above-captioned matter and is

       making this Affidavit in support of his/her Petition for Expungment.

       2. That he/she is _______ years of age, having been born on

       XX/XX/19__. (Only type in the year.)

       3. CHOOSE ONE OF THE FOLLOWING:

               a. That the arrest occurred because of mistaken identity;

                      OR

               b. A Court found there was no probable cause for the arrest;

                      OR

               c. The petitioner was found not guilty in court proceedings;

                      OR
                 d. The expungment would be in the best interests of justice and

       charges have been dismissed or no charges are likely to be filed;

       4. That he/she is [unemployed] or [employed at

________________________________________, and has been since

________________].

       5. That he/she is [single] or [married] and the [father] [mother] of _______

children.

       6. That [he] [she] is a good citizen and it would be in his/her best interest

and in the interest of justice if this expungment would be granted.

       FURTHER AFFIANT SAITH NOT.

       _____________________________

       Affiant

                              ACKNOWLEDGMENT

               BE IT REMEMBERED, that on this _______ day of
       ___________, 20 __, before me, a Notary Public, in and for the County
       and state aforesaid, came __________________________, who is
       personally known to me to be the same person who executed the foregoing
       Affidavit and he/she duly acknowledged the execution of the same.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal the
day and year above written.
_____________________________
Notary Public
  IN THE ___________________________________ JUDICIAL DISTRICT
    DISTRICT COURT, ______________________ COUNTY, KANSAS
                    CRIMINAL DEPARTMENT
___________________________, )
                   Petitioner,)
vs.                           )
                                                Case No.
                              )
THE STATE OF KANSAS,          )
                 Respondent. )


                     ORDER OF EXPUNGEMENT
       NOW on this _______ day of ______________, 20__, this matter comes

on for hearing upon the petitioner's Petition for Expungment filed herein. The

State of Kansas appears by ____________________, Assistant District Attorney.

The defendant appears by and through __________________________________.

There are no other appearances.

       WHEREUPON, the Court, after hearing evidence, reviewing the files,

hearing statements of counsel, and becoming knowledgeable in the premises,

finds as follows:

       1. The petitioner's full name is ____________________________;

       2. The petitioner’s full name at the time of his/her arrest in the above-

entitled action was _____________________________________________;

       3. The petitioner is a ____________ (race) ____________ (sex) who was

born on XX/XX/19___; (Only type in the year.)

       4. The petitioner was arrested in ______________________________

       County, Kansas on the _______ day of _______________________,
       20__; by the ____________________(name of arresting agency), for the

       crime of _____________________________;

       5. CHOOSE ONE OF THE FOLLOWING:

               a. That the arrest occurred because of mistaken identity;

                       OR

               b. A Court found there was no probable cause for the arrest;

                       OR

               c. The petitioner was found not guilty in court proceedings;

                       OR

               d. The expungment would be in the best interests of justice and

       charges have been dismissed or no charges are likely to be filed;

       IT IS, THEREFORE, ORDERED, ADJUDGED AND DECREED that the

defendant's related arrest records should be and is hereby expunged and he/she

shall be treated as not having been arrested.

If the expungment is requested because of section d as listed above the

following must be included:

IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the defendant

shall disclose the arrest herein expunged as follows:

       1. In any application for employment as a detective with a private

       detective agency, as defined by K.S.A. 75-7b01, and amendments thereto;

       as security personnel with a private patrol operator, as defined by K.S.A.

       75- 7b01 and amendments thereto; or with an institution, as defined in

       K.S.A. 76-12a01 and amendments thereto, of the department
       of social and rehabilitation services;

       2. In any application for admission, or for an order of reinstatement, to the

       practice of law in this state;

       3. To aid in determining the petitioner’s qualifications for employment

       with the Kansas lottery or for work in sensitive areas within the Kansas

       lottery as deemed appropriate by the executive director of the Kansas

       lottery;

       4. To aid in determining the petitioner’s qualifications for executive

       director of the Kansas racing commission, for employment with the

       commission or for work in sensitive areas in pari-mutuel racing as deemed

       appropriate by the executive director of the commission, or to aid in

       determining qualifications for licensure or renewal of licensure by the

       commission;

       5. In any application for a commercial driver’s license under K.S.A. 8-

       2,125 through 8-2,142 and amendments thereto;

       6. To aid in determining the petitioner’s qualifications to be an employee

       of the state gaming agency;

       7. To aid in determining the petitioner’s qualifications to be an employee

       of a tribal gaming commission or to hold a license issued pursuant to a

       tribal-state gaming compact;

       8. In any other circumstances which the court deems appropriate.

       IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the

Clerk of the District Court, upon receipt and filing herein, shall send a certified
copy of the Order of Expungment to the Federal Bureau of Investigation, the

Kansas Bureau of Investigation, the Secretary of Corrections, the arresting law

enforcement agency, the District Attorney's Office, the probation department, any

other criminal justice agency which may have a record of the arrest described

herein.

_____________________________

JUDGE OF THE DISTRICT COURT




APPROVED:

______________________________

Assistant District Attorney

______________________________

Attorney for Defendant or Pro Se

				
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