Page 1 of 1 NOT PUBLIC RECORD Approved by the Coalition for Court Access
CCA-XP-0120-7004
www.indianalegalhelp.org
NOT PUBLIC RECORD
FINDINGS AS TO EXPUNGEMENT MATTER
1. Petitioner was ________________ in _________________________ County on ___________________
by ______________________________________, employed by the law enforcement agency known as
______________________________________________ under law enforcement agency case number
______________________________________________.
2. Action taken on arrest charges:
☐ Since the date given above, the ___________________________ County Prosecutor has declined to file
charges related to arrest The following number was assigned: __________________________________.
☐ On ______________________________, Petitioner was _________________________________ under
Cause Number ______________________________ in ___________________________ County, Indiana and
the following charges were filed:
3. Disposition of case:
☐ On _____________________, all charges were either not filed or dismissed by the State before
trial.
☐ On _____________________, following trial, Petitioner was found “not guilty” on all charges.
☐ All _____________________ entered under the aforementioned cause number were vacated on
appeal (appellate cause number _____________________________________), and on
_________________________ the appellate decision became final.
4. Petitioner’s arrest, criminal charges, and/or juvenile delinquency allegations on or about
________________________ did not result in a conviction or juvenile adjudication;
5. Elapsed time:
☐ At least one (1) year has passed between the filing of this petition and either the date of arrest, the
filing of criminal charges, the filing of juvenile delinquency allegation, or the date the appellate opinion
vacating the conviction or juvenile adjudication became final;
☐ Less than one (1) year has passed between the filing of this petition and either the date of arrest, the
filing of criminal charges the filing of juvenile delinquency allegation, or the date the appellate opinion
vacating the conviction or juvenile adjudication became final, but the__________________________
County Prosecutor has consented to a shorter elapsed time period.
6. Related MC cause numbers:
☐ Court records stored under the following MC case/cause numbers constitute records of the
sentencing court or juvenile court for the purposes of this order:
____________________________________________________________________________________
____________________________________________________________________________________
The Court now finds as to Expungement Matter _______that Petitioner’s Verified Petition for Expungement
shall be GRANTED.
___________________________________
___________________________________
