COURT OF COMMON PLEAS HOCKING COUNTY, OHIO CASE NO. Plaintiff, JUDGE vs. APPLICATION TO EXPUNGE A CRIMINAL RECORD OF Defendant. Now comes the Defendant, NON-CONVICTION , pro se, and move for an order sealing the record of the above-captioned case, including the sealing of all criminal records pursuant to Ohio Revised Code §2953.32. Charge(s): Date of Acquittal/Dismissal/No Bill Report: I was found not guilty of a criminal offense by a jury or court; or I was the defendant named in a dismissed complaint, indictment, or information, or A no bill was entered by a grand jury in my case and it has been two years since the foreman or deputy foreman of the grand jury reported to the court that the grand jury reported a no. [A no bill is where the grand jury ignores the charge presented to it.] Motion to Seal a Record of Non-Conviction Page 1 of 3 There are no criminal proceedings against the above-named Defendant. There interests of the Defendant in having his/her records pertaining to this case sealed, are not outweighed by the legitimate governmental needs to maintain such records. Respectfully submitted, ______________________________ Defendant’s Signature Defendant’s Printed Name Address Phone Motion to Seal a Record of Non-Conviction Page 2 of 3 ADDITIONAL INFORMATION RECORD For purposes of identification of the record to be sealed, the following information will be provided to arresting agencies and all known custodians of arrest and conviction records: This information must be filled out to the best of your knowledge. Please print all information. 1. Applicant’s Full Name 2. Applicant’s Maiden Name 3. Applicant’s Full Address 4. Applicant’s Gender 5. Applicant’s Race 6. Applicant’s Date of Birth 7. Court Case Number 8. Charge at Arrest 9. Ohio BCI Number (if known) 10. FBI Number (if known) Motion to Seal a Record of Non-Conviction Page 3 of 3