Summit County Court of Common Pleas Juvenile Division
Application to Expunge Record (Ohio Revised Code § 2151.358)
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Age
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Driver's License Number
Is your driver's license currently suspended?
Yes
No
Social Security Number
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Type of Record Sealed
Delinquency
Traffic
Date of Sealing Order
-
Month
-
Day
Year
Date
Have you been adjudicated or convicted of any juvenile and/or adult criminal or traffic offenses since your last contact with the court?
Yes
No
Date
-
Month
-
Day
Year
Date of offense
Offense
Type of offense
Court or Location
Where was the case handled
Additional Offense?
Yes
Date
-
Month
-
Day
Year
Date of offense
Offense
Type of offense
Court or Location
Where was the case handled
Additional Offense?
Yes
Date
-
Month
-
Day
Year
Date of offense
Offense
Type of offense
Court or Location
Where was the case handled
Please Provide Employment History Below:
Emplolyer
Dates Employed
Reason for Leaving
Employer 1
Employer 2
Employer 3
Employer 4
Please Provide Education History Below:
Name of School
Date of Graduation
Area of Study/Degree
School 1
School 2
School 3
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Do you want to be represented by the Legal Defenders Office regarding the Sealing Hearing ?
*
YES
No
Please indicate any other information you would like the court to know in reviewing your application
BY SUBMITTING THIS APPLICATION I AM REQUESTING THAT THE SUMMIT COUNTY JUVENILE COURT EXPUNGE MY RECORD PURSUANT TO OHIO REVISED CODE § 2151.358
Signature of Applicant
Signature of Parent/Guardian (If applicant is under age 18)
Please note: upon review of your application a court hearing will be scheduled. Please indicate any times that you are not available to appear for a hearing
Submit
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