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.