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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 …

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