PETITION TO SEAL RECORD(S)
UNDER G. L. c. 276, § 100C
TRIAL COURT OF MASSACHUSETTS
PETITIONER'S NAME (please print) PETITIONER'S ADDRESS (please print)
TELEPHONE #
PCF #
DOCKET NUMBER
OFFENSE/CHARGE
(please list each one on a separate line)
DISPOSITION
DATE
DISPOSITION
COURT
USE ONLY
seal
seal
seal
seal
seal
seal
Please see the attached continuation sheet listing additional case(s).
I request this Court to order that the record(s) of the criminal charge(s) listed above be sealed for the
following specific reasons: (Please print and attach documents as necessary)
DATE:
SIGNED UNDER THE PENALTIES OF PERJURY
PETITIONER'S SIGNATURE:
ORDER OF COURT
A hearing on the merits of petition to seal is scheduled on , at
AM
(no sooner than 7 days). The clerk-magistrate shall ensure that notice of the hearing is given to the
probation department and the prosecutor's office, and shall post a copy of the petition on a public
bulletin board until the scheduled hearing. The prosecutor's office is advised to give notice to the
victim(s), if any, and to inform the victim(s) she/he/they may appear and be heard.
PM
After review of the petition and any attachments and/or the preliminary hearing, the Court finds that no
prima facie case in favor of sealing has been shown, and the petition to seal is DENIED.
DATE: JUDGE'S SIGNATURE:
Rev. 1/15
