Form 159 - Application For Expungement Of Arrest Records printable pdf download

Form 159 - Application For Expungement Of Arrest Records

APPLICATION FOR EXPUNGEMENT OF ARREST RECORDS

You may leave blank the spaces on this form that call for your social security number and right thumbprint. There is

presently no law or regulation that requires you to provide them. If you do provide your social security number, right

thumbprint, or both, we will use them only to verify that the correct arrest record is expunged, if you are entitled to an

expungement under Hawaii Revised Statutes, Section 831-3.2.

Current

Name:________________________________________________________________ Sex: M____ F____

(Last, First, Middle)

Other Names Used:______________________________________________ Date of Birth:_____________

Social Security Number:______________________________ Place of Birth:_________________________

_______________________________________________________________________________________

Home Address

City

State

Zip Code

Telephone Number

In accordance with the provisions of Section 831-3.2, Hawaii Revised Statutes, I hereby submit this application to have

my arrest record expunged for the following alleged offense(s) for which no conviction has been secured:

Date of

Place of

Date of Last

Offense

Arrest

Court Appearance

__________________________________________ ___________ ____________________ ________________

If I am found to have no record of conviction, I also request the return of fingerprints and photographs. I hereby declare

that I am not a fugitive from justice.

Mailing Address for all correspondence:

_______________________________________________

Date:___________________ Applicant’s Signature_____________________________________________

Fee Amount: First Time Applicant $35.00

All Others $50.00

Cash or Money Order made payable to State of Hawaii.

NO PERSONAL OR BUSINESS CHECKS ACCEPTED

Right Thumbprint

Return application and money order to:

Arrest Records Expunger

Hawaii Criminal Justice Data Center

Department of the Attorney General

465 S. King Street, Room 101

Honolulu, Hawaii 96813

HCJDC 159 (5/11/2009)

Form 159 - Application For Expungement Of Arrest Records