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Representing [ ] Self or [ ] Lawyer (Arizona Secretary of State)

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Arizona Supreme Court Page 1 of 2 AOC CR41FORM21-010120
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Representing [ ] Self or [ ] Lawyer for
Lawyer’s Bar Number:
COURT OF ARIZONA
IN COUNTY
APPLICANT
(Name/Address/Phone):
Case Number:
APPLICATION
APPLICATION TO
VACATE
CONVICTION FOR A
PRIOR OFFENSE UNDER
A.R.S. § 13-909
AND SUPPORTING
DECLARATION
APPLICANT asks the court to vacate the conviction for the crime of Prostitution, under A.R.S. §
13-3214 or a city or town ordinance that has the same or substantially similar elements as section 13-3214,
committed before July 24, 2014. The conviction occurred on ________________ in this court. This relief
is sought under A.R.S. § 13-909. The law provides that any person so convicted may apply to the sentencing
court to vacate the conviction. The applicant is entitled to relief if the applicant can establish by clear and
convincing evidence that the applicant’s participation in the offense was the direct result of having been a
victim of sex trafficking pursuant to A.R.S. § 13-1307.
Explain how you were a victim of sex trafficking and, as a direct result, were convicted of Prostitution:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
For Clerk’s Use Only
Select a County
Case Number:
Arizona Supreme Court Page 2 of 2 AOC CR41FORM21-010120
If additional information is required, you may attach additional pages on lined paper.
I state under penalty of perjury that the information I have provided on this form is true and correct.
Date: ____________________ Signature: ____________________________________________
Applicant
CERTIFICATE OF MAILING
I CERTIFY that I delivered or mailed a copy of this application to the prosecutor’s office that prosecuted
the case at the following
Address:______________________________________________________________________________
_____________________________________________________________________________________
Date: _____________________ Signature: ___________________________________________
Applicant
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Representing Self or Lawyer (Arizona Secretary of State)

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Completed 27 January 2021

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