Expungement Form

Record Sealing/Expungement Form

First Name

Last Name

Other Name

Date of Birth

Address

City

State

Zip Code

Phone Number

There is a $50 fee imposed by the Clerk’s Office to file an application to seal or expunge a conviction. However, if you complete a financial form that shows you are indigent, that fee can be waived.

No money will be collected at this time but please indicate one of the following:

I can pay the $50 fee.
I would like to waive the fee by completing a financial disclosure form.

For those who would like to waive the fee, please complete and return the Financial Disclosure Form.