APPLICATION FOR EXPUNGEMENT
PLEASE PRINT ALL INFORMATION ON THIS FORM LEGIBLY AND SIGN
YOUR NAME AT THE BOTTOM
FULL LEGAL NAME: ________________________________________________
NAME AS IT APPEARS ON
WARRANT/TICKET/INDICTMENT: ____________________________________
(this may include maiden, alias & nicknames)
CHARGE (S) YOU ARE APPLYING TO GET EXPUNGED __________________
___________________________________________________________________
RACE: ___________ SEX: _________
DATE OF BIRTH: ________________________
SOCIAL SECURITY NUMBER: ______________________________
ADDRESS:
________________________________________________________________________
________________________________________________________________________
______________________________________________________________
PHONE NUMBERS: HOME: _____________________ WORK: ________________
CELL: _____________________
I understand the following:
An application does not guarantee that I can have a charge removed from my criminal
record. Only a thorough research of my criminal record will reveal if I am eligible. I understand
that I may hire an attorney to assist me.
When I use the Solicitor’s Office to prepare and process my request for expungement, the
administrative fee of $250.00 to the Office of the Solicitor is non-refundable;
I hereby acknowledge that I have read and understand the instructions for Expungement Orders,
eligibility and fees, and the Application for Expungement as administered by the Twelfth Circuit
Solicitor’s Office 180 North Irby Street, Box Q, Florence, South Carolina 29501.
It may be possible that outside private entities may obtain a copy
of your record and publish it but this is beyond our control.
____________________________________ __________________________
Defendant Date
Criminal Database Update
by Foundation For Continuing Justice - ContinuingJustice.org
First Name
Last Name
Date of BirthM. Initial
State
Court
County
Street Address (Current)
City State Zip Code
After your case has been expunged, set aside or otherwise modied by the court, you will want to have your criminal record updated
with private databases that provide this information for background checks that are commonly performed by employers, real estate
agents, landlords, and banks. The Criminal Database Update is a free service oered by the Foundation for Continuing Justice that
helps ensure that background check companies have updated your record to accurately reect the court's order.
Complete the form below and attach a copy of your granted order. We will update our criminal record clearinghouse database
which will furnish the data to over 500 independent companies, updating records with criminal background providers nationwide.
Please note, all processing will be handled electronically. Do not provide any additional documentation, we will only accept the
completed form and court granted order. All documents will be discarded once processed.
I authorize the Foundation for Continuing Justice to provide this case information to providers of criminal data information for the
express and limited purpose of updating their records to reect that the criminal record has been cleared or modied in my favor.
SignatureDate
COMPLETE ENTIRE FORM AND ATTACH A COPY OF YOUR SIGNED GRANTED ORDER* AND THEN MAIL TO:
Foundation For Continuing Justice
1504 Brookhollow Dr. Suite 114
Santa Ana, CA 92705
*If you have multiple granted orders please submit this form for each case.
*All fields are required to be filled in. If any fields are left blank, this form will be discarded.
Phone Number
Email Address5HTXLUHG
Any Aliases That May Have Been Used (Separated by comma)
