LA Code Crim Pro art. 993 (2021)
2021 Louisiana Laws|Code of Criminal Procedure|Art. 993. Supplemental forms to be used

  SUPPLEMENTAL SHEET  ____ Yes ____ No ARRESTS THAT DID NOT RESULT IN CONVICTION  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Time expired for prosecution _____/____/_______  (MM/DD/YYYY)  ( ) Charge refused by DA - not prosecuted.  ( ) Pre-trial Diversion Program.  ( ) Charge dismissed  ( ) Found not guilty/judgment of acquittal SUPPLEMENTAL SHEET  ____ Yes ____ No MISDEMEANOR CONVICTIONS  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence.  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 894(B)  ( ) More than 5 years have passed  since completion of sentence. SUPPLEMENTAL SHEET  ____ Yes ____ No FELONY CONVICTIONS  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________   ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense  NO. ___ La. Rev. Stat. Ann. § _______ : ________  Name of the offense _________________  ( ) Conviction set aside/dismissed _____/____/_______  (MM/DD/YYYY)  pursuant to C.Cr.P. Art. 893(E)  ( ) More than 10 years have passed  since completion of sentence  ( ) Received a first offender pardon for an eligible offense   Acts 2014, No. 145, §1; Acts 2018, No. 711, §1; Acts 2020, No. 73, §1.