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      CCRP 994     

  

Art. 994.  Motion for interim expungement form to be used


"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:

_________________


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


ITEM 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 thirty 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 Identification and Investigation 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.



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