Fillable Form MC 227 6/18 State of Michigan APPLICATION TO SET ASIDE CONVICTION

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Form MC 227 6/18 State of Michigan APPLICATION TO SET ASIDE CONVICTION

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Approved, SCAO
Original - Court
1st copy - Defendant
2nd copy - Prosecuting official
3rd copy - Attorney General
4th copy - State Police
5th copy - Return
Court telephone no.Court address
ORI
MI-
Police Report No.
The State of Michigan
THE PEOPLE OF
Defendant’s name, address, and telephone no.
CTN/TCN SID DOB
Defendant’s attorney, bar no., address, and telephone no.
v
STATE OF MICHIGAN
JUDICIAL DISTRICT
JUDICIAL CIRCUIT
APPLICATION TO
SET ASIDE CONVICTION
CASE NO.
MC 227 (6/18) APPLICATION TO SET ASIDE CONVICTION
MCL 780.621, MCL 780.622, MCL 780.772a, MCL 780.827a
1. On
Date
I was convicted of
Offense
. A certified copy of the conviction is attached.
2. I request that the court issue an order to set aside the above conviction as provided by law. I consent to use of the nonpublic
record created by MCL 780.623 to the extent authorized by MCL 780.623.
3. No other application has been filed to set aside this conviction. OR
An application was previously filed to set aside this conviction on
Date
. The application was disposed
of as follows:
.
4. No other application has been filed to set aside another conviction. OR
An application was previously filed in this court the
Court to set aside a
conviction for
, in addition to the conviction in item 1. The application was disposed
of as follows:
.
5. At least five years have passed since sentence was imposed or discharge from imprisonment, probation, or parole for this
conviction, whichever is later.
6. I have not had any convictions deferred and dismissed. I have had the following conviction(s) deferred and dismissed:
.
7. There are no other criminal charges pending against me. There are criminal charges pending against me in the
Court, case number
.
8. I have not been convicted of more than one felony and two misdemeanors as defined in MCL 780.621.
Applicant Signature
Subscribed and sworn to before me on
Date
,
County, Michigan.
My commission expires:
Date
Signature:
Deputy clerk/Notary public
Notary public, State of Michigan, County of
Application to Set Aside Conviction (6/18) Case No.
TO: Michigan Attorney General and
Prosecuting official
A hearing will be held on the above application to set aside conviction on
Date
at
Time
at
Location
before
Judge Bar no.
.
I certify that copies of this application, certified record of conviction, and notice of hearing were served on the
prosecuting official on
Date
by first-class mail addressed to the last-known address.
Attorney General on
Date
by first-class mail addressed to the last-known address.
I certify that copies of this application, certified record of conviction, and the fingerprint card, accompanied by the required fee, were
served on the Michigan State Police on
Date
by first-class mail addressed to the last-known address.
Date
Applicant/Attorney signature
INSTRUCTIONS:
For additional instructions and an online interview that will help you create forms, go to michiganlegalhelp.org.
1. Determine whether you are eligible to apply to have your conviction set aside according to MCL 780.621. You must complete
a separate application for each conviction if you are applying to have more than one conviction set aside.
2. Find out the exact date of conviction and the charge from the court. Get a certified copy of the adjudication and attach it to
your application.
3. Swear to the truth of the statements in this application and then sign it in the presence of the court clerk or a notary public.
4. Make four copies of all attachments and this application. Take all copies to the court clerk.
5. Depending on local practice, the clerk of the court may set a hearing date at the time of filing. If a hearing date is set at the
time of filing, the clerk of the court will complete the Notice of Hearing.
6. Go to the local law enforcement agency for a fingerprint card and get fingerprinted on the applicant card (RI-8). There may
be a fee for fingerprinting. Fill out the card completely.
7. Make out a money order or check to the State of Michigan for the application. The application fee is $50.00. This fee is sent
with the application packet to the Michigan State Police for processing.
8. Mail a copy of the application packet, application fee, and the fingerprint card to the Michigan State Police by first-class mail
to Michigan State Police, Criminal Justice Information Center - Criminal History, PO Box 30266, Lansing, Michigan 48909.
9. Mail a copy of the application packet to the Attorney General of the State of Michigan by first-class mail to Office of the
Attorney General, Criminal Appellate Division, PO Box 30217, Lansing, Michigan 48909.
10. Mail a copy of the application packet to the correct prosecuting official where the conviction occurred (county, city, or
township) by first-class mail. See www.michiganprosecutor.org/about-us-menu/prosecutor-directory for the addresses of
county prosecutors.
11. On both copies of the application, fill in the Proof of Service on the back of the form. After you fill out and sign the Proof of Service,
mail or take one of the remaining application packets with the completed Proof of Service to the court. Keep the other copy
of the application packet for your records.
NOTICE OF HEARING
PROOF OF SERVICE
The hearing cannot be held until the court receives the
Michigan State Police report required by MCL 780.621(9).
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Form MC 227 618 State of Michigan APPLICATION TO SET ASIDE CONVICTION

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Completed 16 December 2019

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