Basic information needed by your attorney to start an Expungement. Typing up is best.
1. Petitioner's name is _____________.
any other name used___________________.
Current address ___________________________________
CITY _____________________________ STATE _______ ZIP __________
CELL-PHONE ________________________________ rev 1/30/20
OTHER PHONE-DAY __________________________
E-MAIL ADDRESS ______________________________________________
REFERRED BY: _______________________________________________
2. Petitioner's date of birth is _______,
Social Security Number is ________
3. Petitioner was charged on [DATE] ________________ for violation of the following:
N.J.S.A. 2C: ______________
type of offense _________________
Town ___________________
Summons/ Warrant/ Complaint # ____________________
[Leave out traffic tickets ex 39:4-49.1. Traffic tickets cannot be expunged]
The original complaint number was ___________
4. This matter was in ___________ County .
5. This matter was heard in the ______________ Municipal Court on __________
6. On [DATE] ______, I plead guilty of the following offense: ________________________.
I was fined _____, costs of ______ and ______.
Or
on ________________, charges were dismissed
7. The following are all othercharges against me since I was 18 year old, even if the charge was dismissed or it was a Municipal Ordinance:
[IF NONE, WRITE NONE]
[OTHER PRIOR CHARGES] Petitioner was charged on ________________ for violation of the following:
N.J.S.A. 2C: ______________
type of offense _________________
Summons/ Warrant/ Complaint # ____________________
Other prior offenses:
This matter was in ___________ County , town ______________
Disposition/ result ___________________________________
[If none, write none, don’t leave blank]
KENNETH VERCAMMEN & ASSOCIATES, PC
ATTORNEY AT LAW
2053 Woodbridge Ave.
Edison, NJ 08817
(Phone) 732-572-0500
(Fax) 732-572-0030
