La. Ch. Code art. 925 — LA Code / Code childrens-code / Article 925
Expungement and sealing; forms
Status: in_force

A. The following form shall be used for filing a motion, setting a contradictory hearing, and ordering the expungement and sealing of records and reports:

MOTION FOR EXPUNGEMENT AND SEALING

NOW INTO COURT COMES _______________________________, in proper person or through undersigned counsel, and herein moves this Honorable Court:

(1) To order the expungement and sealing of all records and reports, including but not limited to the record of arrest and order of disposition concerning the below-described conduct or condition, and directing all officials, agencies, institutions, boards, and systems, including their employees, agents, consultants, and special committees, to expunge and seal any record, in any form, concerning the arrest of mover, and any other photographic, fingerprint, DNA, or any other information of any and all kinds or descriptions; and

(2) To direct each agency and law enforcement office having any such records, including but not limited to the above named entities, to file a sworn affidavit with the clerk of court to the effect that such records have been expunged and sealed and that no notation or reference has been retained in any central depository which could or might lead to the inference that the expunged and sealed record was ever on file with that agency or law enforcement office, except as otherwise specifically provided by law.

I.

Full name of mover:

_________________________________________________________________

SEX: { } Male { } FemaleSocial Security Number:_________

Race/Ethnicity: ____________Date of Birth: ____/____/_____

Address: Street: ______________________________________ Apt. #: _______

City/State: __________________________________________Zip: __________

NOTE: A separate page shall be completed for EACH of the charges for which expungement and sealing is sought. Failure to provide ALL of the requested information may result in dismissal of the motion for insufficiency.

II.

Offense Report #: ___________________Offense charged:________________

Date of Arrest: ____/____/________

Arresting Agency: ___________________________________________________

City/ Parish of Arrest: ________________________________________________

III.

Action taken: (Check appropriate action and insert date)

{ } Charges not filed

{ } Charges refused on____/____/________

{ } Informal Adjustment Agreement completed on____/____/________

{ } Adjudicated on ____/____/________

{ } Dismissed on ____/____/________

{ } Continued without date on____/____/________

IV.

Court Docket and Complaint #: __________________, # _____________

V.

Authority for motion (Check one only)

{ } This matter did not result in adjudication.

{ } This matter resulted in a Families in Need of Services or delinquency adjudication.

AND the court which had exercised juvenile jurisdiction has ceased to exercise such in accordance with Children's Code Article 313.

AND the adjudication was not for murder, manslaughter, an offense requiring registration as a sex offender under R.S. 15:542, kidnapping, or armed robbery.

AND mover has no adult felony conviction and no adult conviction for a misdemeanor against a person involving a firearm.

AND mover has no pending indictment or bill of information against him.

WHEREFORE, mover prays that after due proceedings are had, there be an order herein in favor of mover, ordering the clerk of court and all other agencies, offices or organizations to expunge and seal their records or reports concerning the conduct or condition of mover as a child as more fully described herein.

Respectfully submitted,

_________________________________________

Name of Mover or Attorney

_________________________________________

Address

_________________________________________

City/State/Zip

_________________________________________

Phone

ORDER

CONSIDERING the above and foregoing:

IT IS ORDERED that a contradictory hearing be and is hereby set for the ______ day of _________________, 20____ at _________ in Section ________.

_________________, Louisiana this ______ day of __________________20___.

____________________________________

JUDGE

Note: Please add any additional necessary agencies below.

PLEASE SERVE:

Parish of___________________

District Attorney________________

Clerk of Court _________________

Sheriff________________________

Bureau of Criminal Identification and Information

Attn: Expungements

7919 Independence Blvd.

Baton Rouge, Louisiana 70806

and

_____________________________ __________________________________

Name of Agency Name of Agency

_________________________________ ______________________________

Attn:Attn:

_________________________________ ______________________________

AddressAddress

_________________________________ ______________________________

City/State/ZipCity/State/Zip

B. The following form shall be used to order the expungement and sealing:

ORDER OF EXPUNGEMENT AND SEALING

CONSIDERING the Motion for Expungement and Sealing and the evidence adduced as to the following described matter, and as to the following described conduct or conditions:

Item #s

Offense(s) Charged

Date of Arrest(s)

Arresting Agencies

IT IS ORDERED that the clerk of court expunge and seal all records and reports, in any medium, including but not limited to pleadings, exhibits, reports, minute entries, correspondence, and all other documents. The court may maintain a confidential record of the fact of an adjudication, which may be released only upon written motion of a court exercising criminal jurisdiction over the mover herein and then only for purposes authorized by the Code of Criminal Procedure.

IT IS FURTHER ORDERED that all officials, agencies, institutions, boards, systems, and law enforcement officers and their employees, agents, and consultants expunge and seal all records and reports, in any form, concerning the above-described matter, and any other photographic, fingerprint, DNA, or any other information of any and all kinds and descriptions. The custodian of records and reports of the agency or office may maintain a copy of this order. However, the custodian shall not disclose to anyone the fact that an order is maintained or that the expunged and sealed records or reports previously existed except upon written order of the court.

IT IS FURTHER ORDERED that each agency and law enforcement office herein served and having any records or reports of the conduct or condition file a sworn affidavit with the clerk of court to the effect that the records and reports have been expunged and sealed and that no notation or references have been retained in any central depository which could or might lead to the inference that any report or record was on file with the agency or law enforcement office served, which affidavit shall be filed with the clerk of court within ______ days after service of this order.

Signed at______________, Louisiana this ____ day of _______________20____.

________________________________________

JUDGE

Note: Please add any necessary agencies below.

PLEASE SERVE:

Parish of____________________

District Attorney______________

Clerk of Court_____________________

Sheriff______________________

Bureau of Criminal Identification and Information

Attn: Expungements

7919 Independence Blvd.

Baton Rouge, Louisiana 70806

and

_________________________________ ______________________________

Name of Agency Name of Agency

_________________________________ ______________________________

Attn:Attn:

_________________________________ _____________________________

AddressAddress

_________________________________ ______________________________

City/State/ZipCity/State/Zip

Acts 2017, No. 362, §1.