ATTORNEY OR PETITIONER WITHOUT ATTORNEY (Name, State Bar number, and address):

CR-186/JV-798

FOR COURT USE ONLY

FAX NO. (Optional):

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

ORDER FOR EXPUNGEMENT OF DNA PROFILES AND SAMPLES 
(Pen. Code, § 299)
PETITIONER'S INFORMATION

Court or Arresting Agency Case Number:

NAME: 

CII: 

DRIVER'S LICENSE #: 

SSN # (Last four digits only): 

DATE OF BIRTH:

The court denies the petition.

ORDER

The court grants the petition and orders that petitioner's DNA specimen and sample be destroyed and petitioner's 
searchable database profile be expunged from the California Department of Justice's DNA and Forensic Identification 
Database and Data Bank Program as required by Penal Code section 299. Additionally, the court finds (a) that 
petitioner has made the necessary showing at a noticed hearing, (b) no retrial or appeal of the qualifying case (if any) is 
pending, (c) at least 180 days have passed since petitioner notified the prosecuting attorney and the Department of 
Justice of petitioner's request for expungement, and (d) the court has not received an objection from the Department of 
Justice or the prosecuting attorney. (Pen. Code, § 299(c)(2).)

FOR COURT USE ONLY

Date:

(JUDICIAL OFFICER)

ADDITIONAL INSTRUCTIONS: 
As required by Penal Code section 299(c)(2), the California Department of Justice must destroy petitioner's specimen and 
sample and expunge petitioner's searchable DNA database profile on receipt of this court order, which must also include 
the written petition for expungement, proof of written notice of the petition to the California Department of Justice and the 
prosecuting attorney, and one of the following: 
a. A certified copy of the court order reversing and dismissing the conviction or case; or 
b. A letter from the prosecuting attorney certifying that: 
   (1) no accusatory pleading has been filed; 
   (2) the qualifying charges have been dismissed before adjudication; 
   (3) petitioner has been found factually innocent; 
   (4) petitioner has been found not guilty; 
   (5) petitioner has been acquitted of the underlying offense; 
   (6) the qualifying conviction has been reversed and the case dismissed; or 
   (7) the qualifying sustained delinquency petition has been reversed and the case dismissed.

Form Approved for Optional Use 
Judicial Council of California 
CR-186/JV-798 [New January 1, 2009]

ORDER FOR EXPUNGEMENT OF DNA PROFILES AND SAMPLES 
(Pen. Code, § 299)

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Penal Code, § 299

www.courts.ca.gov