I, ENTER NAME, am the 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. On October 11, 2017, I was arrested by the Seminole County Sheriff’s Office in connection with the charge of Battery- Domestic Violence (M1).
  3. On or about October 28, 2017, the Office of the State Attorney dropped/abandoned the charges brought against me upon the filing of a Notice of No Information.
  4. I have never been adjudicated guilty of any criminal offense or a comparable ordinance violation, nor adjudicated delinquent for committing a felony or a misdemeanor specified in Section 943.051(3)(b), Florida Statutes.
  5. I have not been adjudicated guilty of nor adjudicated delinquent for committing any of the acts stemming from the above-described arrest/notice to appear/citation, or the alleged criminal activity to which my Petition to Expunge a Criminal Record pertains.
  6. To the best of my knowledge and belief, I am eligible for the relief requested in my Petition to Expunge a Criminal Record, and I do not have any petition to seal or expunge pending before any court.
  7. I have never secured a records sealing or expunction under any law of any State.
  8. A Certificate of Eligibility to Expunge a Criminal Record, issued by the Florida Department of Law Enforcement, accompanies my Petition to Expunge.


DATED this _______ day of ___________________________, 2018.



Sworn to and subscribed before me on this ______ day of ___________________________, 2018.




My Commission expires:


Personally known _____ or produced identification _____