Superior Court of California, County of
Fill this out if a criminal complaint was filed or
charged against the petitioner, and there is a case
number and case name for that criminal case. Do
not fill this out if an arrest happened but no
criminal complaint was filed or charged in court:
Trial Court Case Number:
Fill in the name and street address of the court
that you are filing the petition in:
Clerk stamps date here when form is filed.
CR-409
Petition to Seal Arrest and Related
Records (Pen. Code, § 851.91)
Judicial Council of California
www.courts.ca.gov
New January 1, 2019. Optional Form
CR-409, Page 1 of 2
Petition to Seal Arrest and Related
Records (Pen. Code, § 851.91)
v.
Trial Court Case Name:
People of the State of California
Your Information
Petitioner (the person who is filing this petition): a.
Name:
1
Date of birth:
Street address:
Street
City
State Zip
E-mail (if available):
City
Phone:
Mailing address (if you have a lawyer for this case, give your lawyer's
information ):
Street
State Zip
State Bar number:
Information About Your Case
3
Date of the arrest you are requesting to be sealed:a.
Where did the arrest happen? Include the city and county:b.
What law enforcement agency made the arrest? If it was a police department, include the city (for example, ABC
City Police Department). If it was a county sheriff, list the county
c.
d.
What is the arrest report number or police report number, if available?
(for example, XYZ County Sheriff):
Last
First
MI
(mm/dd/yyyy)
(mm/dd/yyyy)
2
Notice of Court Hearing
A court hearing is scheduled on this petition as follows:
Name and address of court if different from above:
Date: Time:
Room:Dept.:
Hearing
Date
If an interpreter is needed, please specify the language:
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Trial Court Case Number:
Trial Court Case Name:
CR-409, Page 2 of 2
New January 1, 2019
Petition to Seal Arrest and Related
Records (Pen. Code, § 851.91)
I am entitled to have this arrest (the arrest described in item of this petition) sealed as a matter of right
because the arrest did not result in a conviction, and I satisfy the requirements of Penal Code section 851.91.
h.
Choose one:
I am requesting to have the arrest sealed in the interests of justice (Pen. Code, § 851.91(c)(2)(B)).
(Describe below how this is in the interests of justice. In deciding whether to grant this request, the court
may consider any important factors, including: hardship and difficulties caused by the arrest; statements
or evidence regarding your good character; statements or evidence regarding the arrest; your record of
convictions; or any other important factors. You may provide statements or evidence from you, from
others, or both.)
OR
Signature of petitioner or attorney
Date:
I declare under penalty of perjury under the laws of the State of California that the foregoing statements are true and
correct, except as to matters that are stated on my information and belief, and as to those matters, I believe them to be true.
g.
If the prosecutor filed a case against you, please include what the charges were (for example, Pen. Code, § 242,
for battery).
Please attach any additional signed and dated statements with the petition.
f.
Add any information on offenses or charges based on the arrest. If you would like to explain the information
provided, please do so below, or complete and attach the Attached Declaration (form MC-031) or submit other
relevant documents.
2
Include any other information about the arrest that is available from the prosecutor (district attorney/city
attorney) or the court, including the case number that the prosecutor used to review the arrest or used to file a
case against you. If you would like to explain the information provided, please do so below, or complete and
attach the Attached Declaration (form MC-031) or submit other relevant documents.
e.
Print this form
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Clear this form
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This Form button after you have printed the form.