Application To Seal A Criminal Record Pursuant Page 2
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4The applicant as stated above qualified as an eligible offender as defined in ORC 2953.31(A).
No criminal or traffic charges are pending against Defendant . (Check the one that applies to
your situation.
This was defendant's first and only conviction. Defendant has never been convicted of
the same crime or any other crime in this or any other state.
Defendant seeks sealing of record on more than one conviction, and all convictions arise
from the same set of facts, that occurred on the same date.
Defendant has other convictions, but they are minor misdemeanors.
The record of the defendant’s conviction(s) should be expunged and all records should be
sealed because Defendant has ben rehabilitated, as evident by the following facts:
Respectfully submitted,
Defendant’s signature
Defendant’s printed name
Address
City/State/Zip
Phone
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