STATE OF LOUISIANA
JUDICIAL DISTRICT FOR THE PARISH OF
______________________________
No.: _____________Division: "_______"
State of Louisiana
vs.
_______________________________________________________
MOTION FOR INTERIM EXPUNGEMENT
NOW INTO COURT comes mover, who provides the court with the following information in connection with this request:
I.DEFENDANT INFORMATION
NAME: ___________________________________________________________
(Last, First, MI)
DOB: ________/______/_______ (MM/DD/YYYY)
GENDER _____ Female _____Male
SSN (last 4 digits): XXX-XX-________
RACE: _________________
DRIVER LIC.# _________________
ARRESTING AGENCY: __________________________________________
SID# (if available): _________________
ARREST NUMBER (ATN): _________________
AGENCY ITEM NO. ________________
Mover is entitled to an interim expungement of the entry of the felony charge(s) of his arrest pursuant to Louisiana Code of Criminal Procedure Article 985.1 and states the following in support:
II.ARREST INFORMATION
1. Mover was arrested on _______/______/_______ (MM/DD/YYYY)
2. _____ YES _____ NO A supplemental sheet with arrests and/or convictions is attached after page 2 of this Motion.
3.Mover was:
_____ YES _____ NO Arrested for a felony offense.
_____ YES _____ NO Convicted of a misdemeanor arising out of that felony offense.
4. Mover was booked and/or charged with the following offenses: (List each offense booked and charged separately. Attach a supplemental sheet, if necessary.)
____ Yes ____ No FELONY ARREST THAT RESULTED IN A MISDEMEANOR CONVICTION
NO. 1 La. Rev. Stat. Ann. § _______ : ________
Name of the offense __________________
__________________
(MM/DD/YYYY)
( ) Felony charge dismissed.
( ) Convicted of misdemeanor offense arising out of
felony arrest.
5. Mover has attached to his Motion a criminal background check from the Louisiana State Police/Parish Sheriff dated within the past sixty days (required).
The mover prays that if there is no objection timely filed by the arresting law enforcement agency, the District Attorney's Office, or the Louisiana Bureau of Criminal Identification and Information, that an order be issued herein ordering the Louisiana Bureau of Criminal Identification and Information to expunge the entry of the felony charge(s) listed contained in the criminal history; and further that the Clerk of Court, District Attorney, and arresting law enforcement agency expunge the entry of those felony charge(s) from any public indices.
If an "Affidavit of No Opposition" by each agency named herein is attached hereto and made a part hereof, Defendant requests that no contradictory hearing be required and the Motion be granted ex parte.
Respectfully submitted,
____________________________________
Signature of Attorney for Mover/Defendant
____________________________________
Attorney for Mover/Defendant Name
____________________________________
Attorney's Bar Roll No.
____________________________________
Address
____________________________________
City, State, ZIP Code
____________________________________
Telephone Number
If not represented by counsel:
____________________________________
Signature of Mover/Defendant
____________________________________
Mover/Defendant Name
____________________________________
Address
____________________________________
City, State, ZIP Code
____________________________________
Telephone Number
PLEASE SERVE:
1. District Attorney______________________________________________
2. Louisiana Bureau of Criminal Identification and Information___________
3. Arresting Agency ______________________________________________
Acts 2014, No. 145, §1; Acts 2018, No. 711, §1.