IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT IN AND FOR MIAMI-DADE COUNTY, FLORIDA
IN THE COUNTY COURT IN AND FOR MIAMI-DADE COUNTY, FLORIDA.
DIVISION
CRIMINAL
JUVENILE
TRAFFIC/MISDEMEANOR
PETITION TO SEAL
CASE NUMBER
THE STATE OF FLORIDA VS.
PLAINTIFF DEFENDANT
CLOCK IN
The petitioner ___________________________, by and through the undersigned attorney, petitions this honorable court, pursuant to
Florida Rule of Criminal Procedure 3.692 and section 943.059, Florida Statutes, to seal all criminal history record information in the
custody of any criminal justice agency and the official records of the court concerning the petitioner's arrest on the ________ day of
_________________, 20___, by_______________________________ (arresting agency), for ____________________________
_________________________________________________________________ (charges), and as grounds therefore shows:
1.On the_____ day of______________________, 20_____, the petitioner,_____________________________________, a
______(race)/______ (sex), whose date of birth is___________________________, was arrested by ________________and
charged with_________________________________________________________________________________________
___________________________________________________________________________________________________.
2. The petitioner has not been previously adjudicated guilty of any of the charges stemming from this arrest or alleged criminal
activity.
3. The petitioner has not been previously adjudicated guilty of a criminal offense or a comparable ordinance violation nor adjudicated
delinquent for committing a felony or a misdemeanor specified in section 943.051(3)(b), Florida Statutes.
4. The petitioner has not secured a prior records expunction or sealing under section 943.0585, or 943.059, Florida Statutes, or
under former section 943.058, 893.14, or 901.33, Florida Statutes.
5. A Certificate of Eligibility for sealing of non-judicial criminal history records issued by the Florida Department of Law Enforcement
accompanies this petition.
WHEREFORE, the petitioner moves to seal any criminal history record information and any official court records regarding his/her
arrest by _____________________________________________ (agency) for _______________________ (charges) on the
________day of _____________________, 20____.
I HEREBY CERTIFY that a true and correct copy of the foregoing pleading has been served on KATHERINE FERNANDEZ
RUNDLE, ( c hec k one) State Attorney for the 11th Judicial Circuit, in and for Mi a m i - Dade County, 1350 Northwest 12
Avenue, Miami, FL 33136: Special Prosecutor, Statewide Prosecutor, (arresting agency); and the Miami-Dade Police
Department, Records Section, 9105 Northwest 25 Street, Miami, FL, 33172, and the Florida Department of Law Enforcement on,
______ day of _________________________, 20 _______.
______________________________________________ _____________________________________________
Signature Print Name
Address:_________________________________________ City-State:_______________________ Zip Code:__________
( )
Telephone Number :________________________________ E-mail Address ______________________________________
Fla. Bar No. : _________________________________________
CLK/CT 410 Rev. 08/19 Clerk’s web address: www.miami-dadeclerk.com
