CLICK HERE for more information on the expungement process.

FORM NOT EFFECTIVE UNTIL 07/2025

Use this form in a domestic violence case. 

Use this form to apply to have police records expunged if you previously requested that a law enforcement agency expunge your police record relating to an incident and you were issued a Notice of Denial of Request for Expungement or you have not been notified of any action taken and it has been more than 60 days after receipt of the Notice and Request for Expungement.

Use this form if requesting to shield domestic violence (CC-DC-DV-021 A or B) or peace order (CC-DC-PO-016 A or B) records and it is earlier than three (3) years after the denial or dismissal of the petition or after the consent expires. This is a release of all the requesting party’s claims for damages relating to this proceeding and  any and all tort claims that may arise out of this  proceeding.

Use this form if requesting to expunge records based on an acquittal, nolle prosequi, or dismissal and it is earlier than three (3) years after the disposition to waive all officers, agents, and employees involved in your arrest, detention, or confinement.

Note: MDJ-004GI must be accompanied by MDJ-010 (Confidentiality Notice)