Sealing Application Form - Defiance County Court Of Common Pleas
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1IN THE COURT OF COMMON PLEAS OF DEFIANCE COUNTY, OHIO
JUVENILE DIVISION
SEALING APPLICATION
(O.R.C. 2151.356)
.
Please Print
Name ______________________________________________________________
Last
First
M.I.
(
Applicant should list name when the juvenile record was obtained, even if different now)
Date of Birth________Current Age ____ Social Security Number ____- ___ - ____
Address_______________________________________________________________
City _________________ State _______ Zip ______ Ph.( _____) - ______ - ________
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Case number(s) requested to be sealed: (
The Juvenile Court clerk will help you if you do not know the case
)
numbers
________________________________________________________________________
________________________________________________________________________
The undersigned applicant hereby requests that the applicant’s record be sealed.
The applicant further states that the applicant is not currently under the
jurisdiction of the court in relation to a delinquency complaint and that at least six
months have passed since the termination of any order made by the Court in relation
to the case, or any unconditional discharge from any institution or facility if the
applicant was committed to an institution or facility in relation to the case.
The applicant also authorizes the release of any school and/or police report that may
aid the court in making a finding in this matter.
Applicant’ s Signature _____________________________
Date _______________
application to seal record ORC 2151.356
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