AOC-496.2 Doc. Code: PEXC
Rev. 7-16
Page 1 of 2
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
KRS 431.078; 218A.275(8);
218A.276(8); 431.079
PETITION FOR EXPUNGEMENT
(FOR MISDEMEANOR, VIOLATION, OR
TRAFFIC INFRACTION CONVICTION)
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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 431.078, to expunge the following
misdemeanor, violation, or trafc infraction charge(s) in the above-referenced case:
CHARGE: ____________________________________ CHARGE: __________________________________
CHARGE: ____________________________________ CHARGE: __________________________________
CHARGE: ____________________________________ CHARGE: __________________________________
In support of this Petition, the Defendant states as follows:
1. The Defendant was convicted of the misdemeanor(s), violation(s) or trafc infraction(s) charged above.
2. The above-stated offense(s) is/are not a sex offense(s) or an offense(s) committed against a child.
3. The Defendant has not, been convicted of a felony or misdemeanor in the ve years prior to the ling of this Petition.
4. The offense(s) is/are not subject to enhancement for a second or subsequent offense or the time for such enhancement
has expired.
5. No proceeding concerning a felony or misdemeanor is pending or being instituted against Defendant.
6. This petition q is led no sooner than ve (5) years after completion of Defendant’s sentence or ve (5) years after
successful completion of the Defendant’s probation, whichever is later; OR q involves Defendant's 1st conviction for
possession of controlled substances voided under KRS 218A.275(8); OR q involves a conviction for possession of
marijuana or synthetic drugs or salvia voided under KRS 218A.276(8).
7. List the names and addresses of all victims of the crimes listed above and any other person(s) whom Defendant/Petitioner
has reason to believe may have information relevant to the expungement:
Victims: __________________________________________________________________________________
_________________________________________________________________________________________
Persons with relevant information: ___________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
NOTE: A SEPARATE PETITION MUST BE FILED FOR EACH CRIMINAL CASE AND THE CHARGE(S) MUST BE
LISTED IN THIS PETITION FOR THE CHARGE(S) TO BE EXPUNGED. ADDITIONALLY, A COPY OF YOUR CURRENT
EXPUNGEMENT ELIGIBILITY CERTIFICATION MUST BE ATTACHED TO THIS PETITION.
Case No. ____________________
Court ____________________
County ____________________
Division ____________________
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