STATE OF TENNESSEE

[___] JUDICIAL DISTRICT

CRIMINAL COURT OF [COUNTY] COUNTY

DIVISION [___]

STATE OF TENNESSEE, )
Respondent, )
) Docket No.: [_]
v. )
) (Former) Case No.: [_]
[PETITIONER FULL LEGAL NAME], )
Petitioner. )

VERIFIED PETITION TO EXPUNGE CRIMINAL RECORD

(T.C.A. § 40-32-101 et seq.)

[// GUIDANCE: File the Petition in the same court—and under the same docket number, if still open—in which the original charge was adjudicated. Verify the county’s local rules for any supplemental forms, hearing requirements, or filing fees/waiver procedures.]

TABLE OF CONTENTS

1. Definitions
2. Jurisdiction & Venue
3. Factual Background
4. Statutory Eligibility & Waiting Period Compliance
5. Affirmative Statements & Representations
6. Requested Relief
7. Notice & Service
8. Verification / Affidavit
9. Prayer for Relief
10. Certificate of Service
11. Proposed Order (Appendix A)

1. DEFINITIONS

For purposes of this Petition, the following terms shall have the meanings set forth below. Terms defined herein and used elsewhere in this Petition (whether or not capitalized) shall have the same meanings unless the context clearly requires otherwise.

a. “Petitioner” means [PETITIONER FULL LEGAL NAME], Social Security No. [XXX-XX-____], Date of Birth [MM/DD/YYYY].
b. “Subject Record” means all arrest, charging, court, and custodial records—including electronic, micro-filmed, and hard-copy formats—pertaining to the offense(s) identified in Section 3 below.
c. “Law-Enforcement Agency” means every local, county, state, or federal agency or official in possession, custody, or control of the Subject Record, including but not limited to the Tennessee Bureau of Investigation (“TBI”).
d. “Eligible Offense” means an offense statutorily eligible for expungement under Tenn. Code Ann. § 40-32-101 et seq.
e. “Expungement Order” means a court order directing destruction or permanent sealing of the Subject Record, subject to the limited sealed-record access permitted by Tenn. Code Ann. § 40-32-101(c).

2. JURISDICTION & VENUE

1. This Court has subject-matter jurisdiction over expungement proceedings pursuant to Tenn. Code Ann. § 40-32-101(a).
2. Venue is proper in this Court because the underlying criminal matter was adjudicated herein and the Subject Record is maintained within this jurisdiction.

3. FACTUAL BACKGROUND

a. Date of Arrest: [MM/DD/YYYY]
b. Original Charging Agency: [Agency Name]
c. Offense Charged: [Offense Caption / Statute]
d. Disposition Date: [MM/DD/YYYY]
e. Final Disposition: [Dismissed / Nolle Prosequi / Not Guilty / Completed Diversion / Class “E” Conviction, etc.]
f. Sentencing (if any): [Fine / Probation / Jail Time]
g. Date All Sentencing Requirements Satisfied (if any): [MM/DD/YYYY]

4. STATUTORY ELIGIBILITY & WAITING PERIOD COMPLIANCE

1. The Subject Record pertains to an Eligible Offense as defined in § 1(d) and specifically qualifies for expungement under the following statutory subsection: [T.C.A. § 40-32-101(a)/(c)/(g), as applicable].
2. The Petitioner has satisfied the statutory waiting period of [X Years/Days] measured from the date of final disposition or completion of sentence, whichever is later, as required by Tenn. Code Ann. § 40-32-101(__).
3. The Petitioner has no outstanding criminal charges, indictments, or informations pending in any jurisdiction.
4. The Petitioner has not been convicted of any other disqualifying offense subsequent to the disposition of the Subject Record.
5. All statutorily-mandated court costs, fines, and restitution related to the Subject Record have been [Paid in Full / Waived by Prior Court Order].

5. AFFIRMATIVE STATEMENTS & REPRESENTATIONS

The Petitioner, after due inquiry and to the best of Petitioner’s knowledge, information, and belief, represents and warrants that:

a. All facts set forth herein are true, accurate, and complete.
b. Petitioner understands that any material misrepresentation may subject Petitioner to criminal penalties, including perjury.
c. Petitioner will immediately notify the Court and the District Attorney General of any change in eligibility status prior to adjudication of this Petition.
d. No previous petition for expungement of the Subject Record has been denied on its merits within the past two years.

[// GUIDANCE: Where the underlying disposition involved a diversion program or a conviction under § 40-32-101(g), attach certified proof of completion and, if applicable, the TBI Criminal Offender Information report.]

6. REQUESTED RELIEF

WHEREFORE, Petitioner respectfully requests that the Court enter an Expungement Order that:

1. Grants this Petition in all respects;
2. Orders the Clerk of this Court, the arresting agency, the TBI, and all other applicable Law-Enforcement Agencies to expunge, destroy, or seal the Subject Record, both paper and electronic, in compliance with Tenn. Code Ann. § 40-32-101;
3. Directs each Law-Enforcement Agency to remove the Subject Record from any public-facing database or index and to transmit written confirmation of compliance to the Clerk of this Court within sixty (60) days of service of the Expungement Order;
4. Permits continued sealed-record access solely for law-enforcement, sentencing, and other statutory purposes expressly authorized by Tenn. Code Ann. § 40-32-101(c); and
5. Provides such other and further relief as justice may require.

7. NOTICE & SERVICE

1. Pursuant to Tenn. Code Ann. § 40-32-101(e), Petitioner has contemporaneously served a copy of this Petition on the Office of the District Attorney General for the [___] Judicial District and on the TBI.
2. The District Attorney General shall have thirty (30) days from the date of service to file any objection to this Petition.

8. VERIFICATION / AFFIDAVIT

I, [PETITIONER FULL LEGAL NAME], being first duly sworn, do hereby verify that I have read the foregoing Verified Petition to Expunge Criminal Record and that the facts stated therein are true and correct to the best of my knowledge, information, and belief.

[PETITIONER SIGNATURE]
[Petitioner Printed Name]
Date: ___

STATE OF TENNESSEE )
COUNTY OF ___ ) ss.

Subscribed and sworn before me this ___ day of ____, 20__.

Notary Public
My Commission Expires: _____

9. PRAYER FOR RELIEF

WHEREFORE, PREMISES CONSIDERED, Petitioner prays that this Honorable Court grant the relief requested in Section 6 above and enter the proposed Expungement Order attached as Appendix A.

Respectfully submitted,

[PETITIONER OR COUNSEL SIGNATURE BLOCK]
Name: [Attorney Name or Pro Se Petitioner]
TN BPR No.: [__]
Address: [___]
Phone: [--_]
Email: [________]

10. CERTIFICATE OF SERVICE

I hereby certify that a true and exact copy of the foregoing Verified Petition to Expunge Criminal Record was served upon the Office of the District Attorney General for the [] Judicial District and the Tennessee Bureau of Investigation, Legal Division, on this ___ day of _, 20__, by [hand delivery / certified mail, return receipt requested / electronic filing & service].

[Name of Server]

11. PROPOSED ORDER (APPENDIX A)

(Submit as a separate document if required by local rule.)

IN THE CRIMINAL COURT OF [COUNTY] COUNTY, TENNESSEE

STATE OF TENNESSEE v. [PETITIONER NAME]
Docket No.: [__]

ORDER GRANTING PETITION TO EXPUNGE CRIMINAL RECORD
(T.C.A. § 40-32-101 et seq.)

Upon consideration of the Verified Petition to Expunge Criminal Record, any response filed by the District Attorney General, and the entire record in this cause, the Court finds that:

1. Petitioner satisfies all statutory criteria for expungement under Tenn. Code Ann. § 40-32-101(__);
2. The statutory waiting period has elapsed;
3. No statutory disqualifications apply; and
4. Good cause exists to grant the requested relief.

IT IS THEREFORE ORDERED, ADJUDGED, AND DECREED that:

A. The Petition is GRANTED.
B. The Clerk of this Court shall expunge and/or seal all records pertaining to the Subject Record, including docket sheets, minute entries, charging instruments, and dispositions.
C. The Tennessee Bureau of Investigation, [Arresting Agency], and all other Law-Enforcement Agencies in possession of the Subject Record shall expunge, remove from public access, or otherwise permanently seal the Subject Record within sixty (60) days of service of this Order and shall file a Certificate of Compliance with the Clerk of this Court within said period.
D. Notwithstanding the foregoing, sealed-record access is permitted solely for law-enforcement, sentencing, or other statutory purposes expressly authorized by Tenn. Code Ann. § 40-32-101(c).
E. Court costs are [Assessed to Petitioner / Waived].
F. The Clerk shall furnish certified copies of this Order to the Petitioner, Petitioner’s counsel, the District Attorney General, and the TBI forthwith.

SO ORDERED on this ___ day of ____, 20__.

JUDGE [Name]
Criminal Court, [Judicial District]
State of Tennessee

[// GUIDANCE:
1. Before filing, confirm the applicable subsection of T.C.A. § 40-32-101 and insert it wherever “[__]” appears.
2. Attach any mandatory local forms (e.g., “Request for Background Check” forms required in some counties).
3. If the Petitioner seeks waiver of the filing fee, file a separate Uniform Civil Affidavit of Indigency and proposed order.
4. Retain proof of service (mail receipts, e-filing confirmations) for at least five (5) years.
]