Motion for Expungement
FORM 2016 EXP 5 1 (L) STATE OF LOUISIANA NO. _________________________ DIV ____ ___________ JUDICIAL DISTRICT COURT VERSUS PARISH OF____________________________ ___________________________________ STATE OF LOUISIANA Motion FOR Expungement NOW INTO COURT comes mover, who provides the court with the following information in connection with this request: I. DEFENDANT INFORMATION NAME: ____________________________ ___________________________ ________________________ (Last Name) (First Name) (Middle Initial) DOB: ________/________/__________ (MM/DD/YYYY) GENDER: _______ Female _______Male SSN (last 4 digits): XXX-XX-________________ RACE: __________________________________ DRIVER LIC.
FORM 2016 EXP 5‐3 (L) Certification Letter from the District Attorney for fee waiver (if eligible). Certification Letter from the District Attorney verifying that the applicant has no convictions or
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