In support of this Petition, the Defendant states as follows: (check all that apply)
At least sixty (60) days prior to filing this Petition, the Defendant was acquitted of the above-listed charge(s) and the
charge(s) was/were not expunged pursuant to KRS 431.076(1)(a);
At least sixty (60) days prior to filing this Petition, the above-listed charge(s) was/were dismissed with prejudice
and said dismissal was NOT in exchange for a guilty plea to another offense and the charge(s) was/were not expunged
pursuant to KRS 431.076(1)(a);
For felony charges, at least three (3) years prior to the filing of this Petition, the above-listed charge(s) was/were
dismissed without prejudice and said dismissal was NOT in exchange for a guilty plea to another offense;
For misdemeanor charges, at least one (1) year prior to the filing of this Petition, the above-listed charge(s) was/were
dismissed without prejudice and said dismissal was NOT in exchange for a guilty plea to another offense; AND
The above-listed felony charge(s) originally filed in District Court has/have not resulted in an indictment by the grand
jury or in an information filed by the Commonwealth’s Attorney, and six (6) months have elapsed since
the date of the District Court decision to hold the matter to the grand jury.
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AOC-497.2 Doc. Code: PEXA
Rev. 7-20
Page 1 of 2
Commonwealth of Kentucky
Court of Justice
www.kycourts.gov
KRS 431.076
Case No. ____________________
Court ________________________
County ______________________
Division ______________________
NOTE: A SEPARATE PETITION MUST BE FILED FOR EACH CRIMINAL CASE AND THE CHARGE(S) MUST BE LISTED
IN THIS MOTION FOR THE CHARGE(S) TO BE EXPUNGED.
The Defendant prays that this Petition for Expungement for Acquittal, Dismissal, or Failure to Indict be granted and that this
Court enter an Order that the following agencies expunge any records in the agencies' custody regarding these charges:
LIST AGENCIES AND ADDRESSES HERE: (Records may be held at multiple agencies. Please identify any government
agency that may have a record of your charge(s) such as, but not limited to, jail facilities or arresting agencies.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
COMMONWEALTH OF KENTUCKY PLAINTIFF
VS.
________________________________________________ NAME DEFENDANT
________________________________________________ ADDRESS
________________________________________________
_________________________________PHONE NUMBER Jail ID Number ________________ (optional)
Defendant's Birthdate: ______________ Defendant's SSN: ______________ Violation/Arrest Date: _______________
( )
Comes now the Defendant herein and petitions the Court, pursuant to KRS 431.076, to expunge the following charges
which were either acquitted, dismissed, or did not result in indictment in the above-referenced case:
CHARGE: _________________________________ CHARGE: _________________________________
CHARGE: _________________________________ CHARGE: _________________________________
CHARGE: _________________________________ CHARGE: _________________________________
PETITION FOR EXPUNGEMENT
(FOR ACQUITTAL, DISMISSAL, OR FAILURE TO INDICT)
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