Art. 998. Motion for expungement form to be used for certain misdemeanor convictions

STATE OF LOUISIANA

JUDICIAL DISTRICT FOR THE PARISH OF

______________________________

No.: _____________Division: "_______"

State of Louisiana

vs.

_______________________________________________________

MOTION FOR EXPUNGEMENT FOR MISDEMEANOR CONVICTION FOR A FIRST OFFENSE POSSESSION OF MARIJUANANOW 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 expunge the record of his arrest/conviction pursuant to Louisiana             Code of Criminal Procedure Article 971 et seq. and states the following in support:

II. MISDEMEANOR CONVICTION FOR A FIRST OFFENSE POSSESSION OF MARIJUANA

            1. Mover was convicted on _______/______/_______ (MM/DD/YYYY)

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 expungement of the record of arrest and/or conviction set forth above, including all photographs, fingerprints, disposition, or any other such information, which record shall be confidential and no longer considered a public record, nor be made available to other persons, except a prosecutor, member of a law enforcement agency, or a judge who may request such information in writing, certifying that such request is for the purpose of prosecuting, investigating, or enforcing the criminal law, for the purpose of any other statutorily defined law enforcement or administrative duties, or for the purpose of the requirements of sex offender registration and notification pursuant to the provisions of R.S. 15:541 et seq. or as an order of this court to any other person for good cause shown, or as otherwise authorized by law.

            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

            Acts 2023, No. 342, §1.