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IN THE MUNICIPAL COURT OF THE CITY OF (City of Salina)

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IN THE MUNICIPAL COURT OF THE CITY OF SALINA, KANSAS
CITY OF SALINA, Plaintiff,
vs. Case No. __________________
____________________________________________, Defendant.
COMES NOW _______________________________, Defendant/Petitioner, and requests the Court order
expungement of the
PETITION FOR EXPUNGEMENT
____ conviction and related arrest records (OR)
____ diversion and related arrest records.
In support of this request, I state:
1. My full legal name is _________________________________________________.
2. My full name at the time of my arrest was (if different than stated above)
_____________________________________________________.
3. I am a ______________________ (race/sex), born on __________________________________.
4. My Social Security number is XXX-XX-_____________.
5. I was arrested by the Salina Police Department on ______________________ (date) on a charge of
___________________________________________________________.
6. I was convicted of the charge of _______________________________________________________
on ___________________________________ (date) in Salina Municipal Court. (OR)
I was granted a diversion on the charge of ________________________________________________
on ___________________________________ (date) in Salina Municipal Court.
7. More than _______ years have passed since I completed my sentence, OR was discharged from
probation, parole or a suspended sentence, OR since I fulfilled the terms of the diversion agreement.
8. I have not been convicted of a felony in the past two years and no proceeding involving any such crime is
presently pending or being instituted against me.
9. My circumstances and behavior warrant the expungement.
10. The expungement is consistent with the public welfare.
WHEREFORE, Petitioner respectfully requests that the Court enter an order expunging the conviction or
diversion and the related arrest records as set forth above, and grant such other and further relief as the Court deems
just and equitable.
____________________________________
Defendant
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IN THE MUNICIPAL COURT OF THE CITY OF (City of Salina)

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Completed 6 April 2021

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