Seal and Expunge
Request Type:
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Early Juvenile Expunction
Expunge
Juvenile Diversion
Lawful Self-Defense
Seal
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Last Name :
First Name :
Middle Name :
Alias Last Name 1 :
Alias First Name 1 :
Alias Middle Name 1 :
Alias Last Name 2 :
Alias First Name 2 :
Alias Middle Name 2 :
Alias Last Name 3 :
Alias First Name 3 :
Alias Middle Name 3 :
Alias Last Name 4 :
Alias First Name 4 :
Alias Middle Name 4 :
Date of Birth :
Sex :
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Female
Male
Unknown
Race :
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American Indian or Alaskan Native
Asian
Black
Unknown
White
Phone :
Social Security Number :
Mailing Address :
Address Line 1 :
Address Line 2 :
City :
State :
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AS
GU
VI
BK
CZ
HO
JI
JR
KI
MK
PL
VL
WK
MH
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
PR
CG
Zip :
Permanent Address :
Address Line 1 :
Address Line 2 :
City :
State :
Select One
AS
GU
VI
BK
CZ
HO
JI
JR
KI
MK
PL
VL
WK
MH
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
PR
CG
Zip :
Florida Driver's License Number :
Email Address :
Diversion Program Completion Date :
Arrest Charge(s)
Arresting Agency :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
Date of Arrest :
Charge :
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