NOTE TO PETITIONER: List the arresting agency and any State or local government agency that has a record of your case. You must provide complete information for each agency.
The clerk of superior court will send a copy of this order, if granted, to the agency name(s) and address(es) provided below. The clerk will not provide addresses for you. Do not list the
courts, the State Bureau of Investigation, the Department of Public Safety, or the Division of Motor Vehicles; if the order is granted, those agencies will be notified automatically. Do not list
any private entity, like a company that provides criminal background checks. The clerk will not send a copy of this order to any entity that is not an agency of the State of North Carolina or
one of its local governments. A private entity required to expunge records will be notified directly by the State or local agencies that distribute criminal justice information to that entity.
PETITION AND ORDER OF EXPUNCTION
UNDER G.S. 15A-146(a) AND G.S. 15A-146(a1)
(CHARGE(S) DISMISSED)
G.S. 15A-146, 15A-150
Name And Address Of Petitioner (type or print full name)
STATE VERSUS
Full Social Security No. Age At Time Of Offense
Drivers License No. State Race Sex
Date Of Birth
Name And Address Of Petitioner’s Attorney For Expunction Petition
STATE OF NORTH CAROLINA
County
File No. Scan No.(s) (Ofcial Use Only)
In The General Court Of Justice
District Superior Court Division
Name And Address Of Arresting Agency Name And Address Of Other Agency (if any) Name And Address Of Other Agency (if any)
Check here to indicate that additional agencies and/or additional file nos. and offenses are listed on an AOC-CR-285 form that is attached to this
petition. (attach form)
File No.(s)
Date Of
Disposition
Date Of
Offense
Date Of
Arrest
DispositionOffense Description
(Over)
I certify that this petition has been filed in this case and that the information set forth above is a complete and accurate statement of the information on file
in the office of the clerk of superior court. I hereby request and authorize a name-based State and national criminal record check by the NC Department of
Public Safety.
No charge listed above was dismissed as the result of compliance with a deferred prosecution agreement or a conditional discharge and dismissal.
NOTE TO CLERK:
If this box is checked, do not assess the $175.00 fee.
Date Name Of Presiding Judge (type or print) Signature Of Presiding Judge
Date Name (type or print)
Signature
To The State Bureau Of Investigation, Attn: CIIS Expungement Unit, PO Box 29500, Raleigh, NC 27626:
Please prepare, certify on the reverse side, and attach to this Request any Criminal History Record Information (CHRI) for the petitioner, then forward this Request with CHRI
attached, confidentially to: Records Officer, Administrative Office of the Courts.
To The Records Officer, Administrative Office Of The Courts, PO Box 2448, Raleigh, NC 27602:
Complete the report on the reverse side and return it, along with the information attached by the SBI, to the clerk of superior court.
REQUEST BY JUDGE
Petitioner
Petitioner’s Attorney
PETITION TO EXPUNGE
I hereby petition for an expunction pursuant to G.S. 15A-146(a) and (a1) and certify as follows:
1. In this court of the county named above I was charged with (a) misdemeanor(s) or felony(ies) (or an infraction under G.S. 18B-302(i) prior to
December 1, 1999), the file number(s) of which is/are set out above.
2. The charge(s) listed above was/were disposed of by a dismissal.
3. I have not previously been convicted of any felony.
4. There is a civil revocation record that resulted from the offense(s) I am seeking to expunge.
AOC-CR-287, New 4/18 (replaces AOC-CR-264 for G.S. 15A-146(a) and (a1) petitions)
© 2018 Administrative Ofce of the Courts
CRIMINAL HISTORY RECORD INFORMATION
To Any Presiding Judge In The Above-Named County And Court: (Confidential)
I have conducted a search of the criminal records of the North Carolina State Bureau of Investigation and the Federal Bureau of Investigation, based on the
information provided, which has not been verified by fingerprint comparisons, and certify that
there is no criminal record for the petitioner other than the offense(s) identified on the reverse of this form.
the Criminal History Record Information which is attached is a true and accurate statement of all information contained in the criminal records of the
State and Federal Bureaus of Investigation for the petitioner identified on the reverse side of this form.
Name Of SBI Ofcial (type or print)Date SID No. Signature Of SBI Ofcial
REPORT BY ADMINISTRATIVE OFFICE OF THE COURTS
To Any Presiding Judge In The Above-Named County And Court: (Confidential)
I have not searched the NCAOC’s confidential expunction file because a prior expunction search is not required for an expunction under G.S. 15A-146.
After a hearing on the petition/motion, the Court makes the following findings of fact:
1. Petitioner was charged with those offenses indicated on Side One.
2. Said charges were disposed of as indicated in the Petition on Side One.
3. There is a civil revocation record that resulted from the offense(s) the petitioner is seeking to expunge.
4. Petitioner has not previously been convicted of a felony.
5. Petitioner is is not eligible for an expunction of the offense(s) listed on Side One. If not eligible, it is because:
.
FINDINGS OF FACT
Date Signature Of Records OfcerName Of Records Ofcer (type or print)
Ashley M. Naleimaile
Therefore, the Court hereby ORDERS:
1. The petition is granted. It is ordered that any and all entries relating to the petitioner’s apprehension, charge, trial, or conviction and any civil
revocation of his/her drivers license resulting from the criminal charge shall be expunged from the records of the court. All law enforcement agencies,
the Division of Adult Correction and Juvenile Justice of the Department of Public Safety, the Division of Motor Vehicles, and any other State or local
government agency identied on Side One and on any AOC-CR-285 form that is attached to this petition shall expunge from all ofcial records any
entries relating to the person’s charge, conviction, if any, and any civil revocation of his/her drivers license resulting from the criminal charge. No
agency shall expunge a record of a civil revocation entered pursuant to G.S. 20-16.2, no agency shall expunge a record of a civil revocation prior
to the nal disposition of any pending civil or criminal charge based upon the civil revocation, and the Division of Motor Vehicles shall not expunge
records for which expunction is otherwise prohibited by G.S. 15A-151.
2. For the reason(s) identied in Finding No. 5, the petition is denied.
NOTE TO CLERK: If denied, le this Order in the case le. Upon expiration of the deadline for appeal from a denial of this Order, destroy any documentation provided with the
petition, such as a criminal history report. If granted, send a certied copy of this Order to the petitioner at the address listed on Side One or an updated address as provided by
the petitioner.
ORDER
Date Signature Of Presiding JudgeName Of Presiding Judge (type or print)
CERTIFICATION BY CLERK
I hereby certify that this form is a true and complete copy of the original in this case, and if granted, a certified copy of this Order was sent on the date
shown below to the petitioner, the State Bureau of Investigation, the Department of Public Safety, the Division of Motor Vehicles, and to the arresting
agency and any other State or local government agency identified on Side One and on any attachment to this petition.
Signature Of ClerkDate
Name (type or print)
Dep. CSC Asst. CSC
Clerk Of Superior Court
NOTE TO CLERK:
If granted, always send a certified copy of this Order under seal to the petitioner, to all the agencies listed in Certification By Clerk above, and to
the NCAOC. Send copies for the arresting agency and additional agencies to the addresses provided by the petitioner. Send SBI, DPS, DMV, and NCAOC copies to:
NOTE TO PETITIONER: If this petition is granted, the clerk of superior court will send you a certified copy of the final order for your records at the
address listed on Side One. If you move, you must notify the clerk in writing of your change of address in order to receive a certified copy. After the case is
expunged, the clerk of superior court will have no record of the case and will be unable to provide you with any documentation of the case. This includes
the expunction order; it will be destroyed with the case file.
State Bureau of Investigation
Attn: Expunction Unit
PO Box 29500
Raleigh, NC 27626
NC Division of Motor Vehicles, Driver and
Vehicle Services, Driver Assistance Branch
Attn: Hearings/Adjudication Unit
3118 Mail Service Center
Raleigh, NC 27699-3118
NC Administrative Office of the Courts
Court Services Division
Attn: Records Officer
PO Box 2448
Raleigh, NC 27602
NC Department of Public Safety,
Attn: Combined Records Section
4226 Mail Service Center
Raleigh, NC 27699-4226
SEAL
AOC-CR-287, Side Two, New 4/18 (replaces AOC-CR-264 for G.S. 15A-146(a) and (a1) petitions)
© 2018 Administrative Ofce of the Courts
