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CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing pleading has been served on the State Attorney's Office this __ day of __________ Signature Print Name: Address: City/State: Zip: Telephone: cc: Seal &Expunge Dept., State Attorney's Office, 220 East Bay Street, Jacksonville. FL 32202 Jacksonville Sheriffs Office Clerk of Court Florida Department of Law Enforcement
IN THE CIRCUIT/COUNTY COURT OF THE FOURTH JUDICIAL CIRCUIT. IN AND FOR DUVAL COUNTY. FLORIDA CASE NO.: DIVISION: STATE OF FLORIDA, Plaintiff, vs. (Name} ____________________ Petitioner. AFFIDAVit STATE OF FLORIDA ) COUNTY OF DUVAL ) I, • am the defendant/petitioner in the above-styled cause and I do hereby swear or affirm that: 1. I fully understand the meaning of all of the terms of this affidavit. 2. I have never been adjudicated guilty ofa crim in al offense or a comparable ordinance violation. 3. I was arrested on the day of , by the Jacksonville Sheriffs Office, and I have not been adjudicated guilty ofthe charges stemming from that arrest or the alleged criminal activity surrounding my arrest. 4. I am eligible for the relief requested, to the best of my knowledge and belief. and do not have any other petition to expunge or seal pending before any court. 5. 1have never secured a prior records expunction or sealing under any law. Signature Sworn to and subscribed before me this day of ______________ NOTARY PUBLIC Printed, typed or stamped commissioned name of Notary Public
Page 1 and 2: TO OBTAIN SEALING/EXPUNGING CERTIFI
Page 3 and 4: Most Frequently Asked Questions I
Page 5 and 6: Most Frequently Asked Questions o
Page 7 and 8: Most Frequently Asked Questions Wi
Page 9 and 10: REASONS AN APPLICATION FOR CERTIFIC
Page 11 and 12: GENERAL INSTRUCTIONS & INFORMATION:
Page 13 and 14: FINGERPRINTS FOR APPLICATION FOR C
Page 15 and 16: ::tISVJ V DNIDNJldX:tI HO~ S~N:tIW
Page 17 and 18: 6. A Certificate of Eligibility for
Page 19 and 20: IN THE CIRCUIT/COUNTY COURT OF THE
Page 21 and 22: All costs of certified copies invol
Page 23: IN THE CIRCUIT/COUNTY COURT OF THE
Page 27: All costs of certified copies invol

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