Tennessee Expungement Of Criminal Record Form(nashville)

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Tennessee Expungement Of Criminal Record Form(nashville) Powered By Docstoc

State of Tennessee vs.__________________________________Circuit Docket No.______________________
                                                                        General Sessions Docket No.______________________

 In the ________________Court of ____________________ County, Tennessee at____________________________

                           On Motion or Petition of________________________________________
Defendant/Arrest Information:

_____________________________________________________________ _____ _____ __________
Defendant (Name Used at Time of Arrest                                                                       Race      Sex       Date of Birth
______________________________________________________________ ___________                                                       __________
 Arresting Agency                                                                                            OCA#              Date of Arrest
______________________________________________________________ ________________________
 Charge 1 (As shown on Arrest Fingerprint Card)                                                              SSN #
 Charge 2 (As shown on Arrest Fingerprint Card)
 Charge 3 (As shown on Arrest Fingerprint Card)

Disposition Information:
 Final Charge 1
 Final Charge 2
 Final Charge 3
Final Disposition
 Diversion Date (if applicable)

    The defendant named above is entitled to have all PUBLIC RECORDS relating to the offense listed above expunged according to the
Tennessee Code Annotated provision marked below:
      Provisions Relating to Adults:                                          Provisions Relating to Juveniles:
   ____ Charge has been dismissed (TCA 40-32-101)                          ____ Petition alleging delinquency not filed (TCA 37-1-155)
   ____ No true bill returned by Grand Jury (TCA 40-32-101)                ____ Proceedings dismissed after petition is filed or the case
   ____ Verdict of not guilty returned by jury (TCA 40-32-101)                     is transferred to the Juvenile Court as provided in TCA
   ____ Conviction which has by appeal been reversed (TCA                         37-1-109 (TCA 37-1-155)
          40-32-101)                                                       ____ Adjudicated not to be a deliquent child (TCA 37-1-155)
   ____ Nolle prosequi entered in case (TCA 40-32-101)                     ____ Child has reached eighteen (18) years of age and there
   ____ Successful completion of all probation provisions and                     is no record that he committed a criminal offense after
         proceedings against Defendant have been discharged by the                reaching sixteen (16) years of age, unless such finger-
         court (TCA 40-35-313)                                                    prints were obtained on alleged charge which if commit-
   ____ Suspension of prosecution pursuant to TCA 40-15-105                       ted by an adult would be a felony (TCA 37-1-155)
                                                                           ____ Passage of six (6) months from date of liquor law
                                                                                 violations defined by TCA 57-3-412(a)(3)(c) or TCA

     It is ordered that all PUBLIC RECORDS relating to such offense above referenced be expunged and immediately destroyed upon payment
of all cost to clerk and that no evidence of such records pertaining to such offense be retained by any municipal, county or state agency, except
non-public confidential information retained in accordance with TCA 10-7-504 and TCA 38-6-118
                                                   APPROVED FOR ENTRY

_______________________________________                                  Entered this __________day of ___________, ______
Defendant/Attorney for Defendant                                          _____________________________________________________
                                                                          ______________Court of ____________________County
AOC-                                                                                                                     RDA Pending