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
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