Application For Identity Theft Expunction In Collin County (Page 3 of 4) in pdf

Application For Identity Theft Expunction In Collin County Page 3

Application for Identity Theft Expunction in Collin County

Please complete the entire application and attach any additional documentation

you have that may support your claim. If you cannot provide certain information, please

explain why.

I. Applicant Information

Name:

____________________________________________________________

Sex:

M / F

Race:

____________________________________________________________

Date of Birth: ____________________________________________________________

Driver’s License Number: __________________________________________________

Social Security Number: ___________________________________________________

Address (at the time of the arrest): ____________________________________________

____________________________________________

Telephone number: _______________________________________________________

(So the District Attorney’s Office can contact you when your order is ready)

II. Offense Information

Name of arrested person (if known):__________________________________________

Date of arrest:

_______________________________________________________

Offense charged:

_______________________________________________________

Name of county and municipality of arrest: ____________________________________

Name of arresting agency: __________________________________________________

III. Identity Theft Information

Please explain the details of how your identity was stolen, if known. Include any known

relationship between yourself and the arrested person (eg, familial, acquaintance,

Application For Identity Theft Expunction In Collin County Page 3