Published: 05/2016, CN: 11980 (Municipal Instructions and Forms for Expungement of Arrest or Charge Records) page 1 of 1
Instructions and Forms for Expungement of Arrest or Charge Records
N.J.S.A. 2C:52-6
These forms are ONLY provided upon request and at the time of disposition to persons seeking the expungement of arrest
or charge records relating to a disorderly persons offense, petty disorderly persons offense, or municipal ordinance violation,
where those proceedings were dismissed, the person was acquitted, or the person was discharged without a conviction or
finding of guilt. These forms are not to be used to expunge arrest or charge records where the dismissal, acquittal, or
discharge resulted from a plea bargaining agreement involving the conviction of other charges. The process requires
the completion of the following three steps.
Step 1: Complete the Application for Expungement of Arrest or Charge Records
The Application is used by the Municipal Court to determine whether the Applicant is eligible for an expungement of the
arrest(s) or charge(s). The Applicant must complete sections A, B, and C of the form. Section A requires the personal
information of the Applicant. Section B requires the identification of the arrest or charges that the Applicant seeks to have
expunged. The Applicant must provide the date of the arrest, the statute or ordinance the Applicant was charged with
violating, and the complaint number. If the Applicant does not have some or any of this information, the Applicant can obtain
a printout of the case disposition from staff of the municipal court where those proceedings were dismissed, the Applicant
was acquitted, or the Applicant was discharged without a conviction or finding of guilt. If a printout is obtained, the
Applicant should attach it to the Application. The Applicant may alternatively search for the complaint number by accessing
the Municipal Court Case Search via the NJMCdirect website, http://www.njmcdirect.com. Section C requires the Applicant
to date and sign the request for expungement.
Step 2: Complete the Order for Expungement of Arrest or Charge Records
The Order is the official document that will be reviewed and, if granted, signed by the Superior Court Judge. The Instructions
for Completion of the Order are listed below. All questions regarding the completion of the Order should be directed to
the County Criminal Division at ,
contact information .
1. At the top left-hand corner, fill in full name and address.
2. Do not fill in the box marked "For Superior Court Use Only." This will be completed by the Criminal Case
Management Office.
3. In the box where it states, "In the Matter of the Expungement of the Arrest/Charge Records of _______________,"
print full name.
4. In the first sentence of the Expungement Order, print full name, date of birth and your State Bureau of Identification
(SBI) number, if available, where it is indicated.
5. Leave the next three spaces blank where it states "IT IS ORDERED this ___ day of __________, ______________."
They will be filled in by the court.
6. After "all information relating to," fill in full name.
7. On lines 1-5, provide the date of the arrest or issuance of the complaint, the statute or ordinance charged with
violating, and the complaint number. This information should be identical to that contained in Section B of the
Application for Expungement of Arrest or Charge Records. If more than five rows are needed, attach a separate
sheet of paper with the additional information.
8. Leave the signature line on the next page blank. This is where the judge will sign the order.
Step 3: Submit the Forms for Expungement of Arrest or Charge Records to the Municipal Court
Upon completion of the Application and Order, the Applicant must submit the completed Forms via either hand delivery or
mail to the municipal court where those proceedings were dismissed, the Applicant was acquitted, or the Applicant was
discharged without a conviction or finding of guilt. The Application will then be reviewed by a Municipal Court Judge. If
approved, the Municipal Court Judge will sign the Application and forward the signed Application and Order to the
Applicant and the County Criminal Division for submission to the Superior Court Judge. In the event the Application is
improperly or incompletely filled out, the Applicant will be notified by municipal court staff. After review by a Superior
Court Judge, and if granted, a copy of the signed Application and executed Order for Expungement will be forwarded to the
appropriate prosecutor and Municipal Court for the expungement of applicable records. A copy of the signed Application and
executed Order will also be forwarded to the Applicant.
Published: 05/2016, CN: 11980 (Municipal Application for Expungement of Arrest or Charge Records) page 1 of 1
Application for Expungement of Arrest or Charge Records
N.J.S.A. 2C:52-6
A. Applicant Information
Name: Last First Middle
Date of Birth State Bureau of Identification Number (SBI), if available Telephone Number
Home Address: Street
City State Zip Code
B. Arrest/Charge(s) to be Expunged
(1)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(2)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(3)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(4)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(5)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
If more than five rows are required, please check the box and attach a separate sheet of paper with the additional
information.
C. Relief Sought
I am requesting that the Superior Court grant me an Expungement Order as authorized by N.J.S.A. 2C:52-6, directing the
Municipal Court Administrator, Clerk of the Court, and all relevant criminal/juvenile justice and law enforcement services of
the State of New Jersey to expunge from their records all evidence of the arrest or charge, and all proceedings in this matter,
and further directing any New Jersey law enforcement agency which sent records of the arrest or charge and proceedings to
the Federal Bureau of Investigation or any other law enforcement agency outside of New Jersey to inform the recipient and
the agencies designated to retain control of expunged records to take sufficient precautions to ensure that such records and
information are not released.
Date
Signature
If a printout of the complaint disposition has not been attached by the Applicant, all dispositions referenced above
must be printed and attached by municipal court staff prior to review by the Municipal Court Judge.
For Municipal Court Use Only
The offense(s) listed in the above Application was/were dismissed, acquitted, or discharged without a conviction or a
finding of guilt and was/were not the result of a plea bargaining agreement involving the conviction of other charges.
Date Municipal Court Judge’s Signature
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Print
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Published: 05/2016, CN: 11980 (Municipal Order for Expungement of Arrest or Charge Records) page 1 of 2
Order for Expungement of Arrest or Charge Records
For Superior Court Use Only
(your name)
Superior Court of New Jersey
Law Division
(your address)
County
(city, state, zip code)
Expungement
Reference Number:
Appearing Pro Se
Calendar Date:
In the Matter of the Expungement of the Arrest/Charge
Records of
Civil Action
Expungement Order
(your name)
This matter having been opened to the Court upon the above Application of
(your name)
whose date of birth is
(date)
, and
State Bureau of Identification (SBI) number, if available, is
(SBI number, if available)
, and it
appearing that the requirements for Expungement under N.J.S.A. 2C:52-6 have been satisfied;
It Is Ordered this
day of
,
, that the
The Attorney General of New Jersey,
The Superintendent of the New Jersey State Police, Expungement Unit,
The County Prosecutor,
The Municipal Court Administrator,
Chief(s) of the Police Department(s),
The Warden of the Jail,
The Superintendent of Juvenile Detention Facility, and
The Deputy Clerk of the Superior Court of New Jersey, Criminal Division, receiving this Order must remove from their
records all information relating to
’s
(1)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(2)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(3)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(4)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
(5)
(date)
arrest on/issuance of
(complaint number)
on the charge of violating
N
.J.S.A./Ordinance
;
and remove all records concerning the subsequent proceedings regarding such charge(s), and place such information in the
control of a person within the office designated to retain control over expunged records;
Published: 05/2016, CN: 11980 (Municipal Order for Expungement of Arrest or Charge Records) page 2 of 2
IT IS FURTHER ORDERED that any of the recipient officers or agencies which sent fingerprints and/or any records of the
above arrest(s)/charge(s) and proceedings to the Federal Bureau of Investigation or any other office or agency shall notify same
of this Order and that the agencies designated to retain such records take sufficient precautions to insure that such records and
information are not released;
IT IS FURTHER ORDERED that any records, or the information therein, shall not be released except as provided under the
provision of N.J.S.A. 2C:52-1, et seq. and that the persons designated to retain control over expunged records take sufficient
precautions to insure that such records and information are not released;
IT IS FURTHER ORDERED that in response to requests for information or records, the court office or law enforcement agency
shall reply with respect to the arrest/charge, which is the subject of this Order, that there is no record;
IT IS FURTHER ORDERED that the arrest/charge, which is the subject of this Order, shall be deemed not to have occurred,
and the person subject to this order may answer accordingly any question relating to this occurrence pursuant to N.J.S.A. 2C:52-
27;
IT IS FURTHER ORDERED that this Order does not expunge the records contained in the Controlled Dangerous Substance
Registry created pursuant to P.L. 1970, c. 227 (C.26:2G-17 et seq.) or the registry created by the Administrative Office of the
Courts pursuant to N.J.S.A. 2C:43-21.
IT IS FURTHER ORDERED that a copy of this Application and Order shall be forwarded to the appropriate court and
prosecutor; and
IT IS FURTHER ORDERED that the
receiving prosecutor shall promptly identify and distribute copies of this
Order
to appropriate clerks of courts, law enforcement agencies, and correctional institutions who have custody and control
of the records, including those identified in this Order, so that they may comply with this Order and the requirements of N.J.S.A
2C:52-15.
Date Judge, Superior Court of New Jersey
Copy of Application
and Order only to:
Municipal Court
County Prosecutor
Person subject to this
Order
F
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