ةعطاقم
،
 
 
_________________
 
 
PENNSYLVANIA

دحلاا ةمكحم يف
ا
ث
 
ف
ي
 

 

 

JUVENILE DIVISION 
دحلاا مسق
ا
ث
 

 

DOCKET NO:   
ةظفاحلا مقر
 

 

 

رمأ
 

ORDER 

 
AND NOW, this ____________ day of ____________, 20 ______, 
the Motion for Expungement presented by 
____________________ is _______________________________ 
 

  It is ORDERED that the record in this matter shall be 
expunged, and any fingerprints or photographs taken 
shall be destroyed. 

 
The Court specifically directs that the following items shall be 
expunged: 

 بلط ،
 

____20

_ ماعل __________ رهش نم ___________ مويلا يف

،نلآاو
 متي ____________________ نم مدقملا بطشلا
_______________________
 

 

 

 يأ ريمدت بجي كلذكو ةيضقلا هذه يف لجسلا بطشب
 

 
 رادصا اذهب مت دقل
 .اهطاقتلا مت ةيفارغوتوف روص وا تامصب
 

رمأ

 

 

 

 :يلي ام بطشب اًديدحت ةمكحملا رمأت
 

The Court specifically directs that the following items shall be 
destroyed: 

 

:يلي ام ةدابإب اًديدحت ةمكحملا رمأت

The keeper of the juvenile records shall expunge the following 
items: 

 

:يلي ام بطش ثادحلأا تلاجس ىلع مّيقلا ىلع
 

The keeper of the juvenile records shall destroy the following items: 

 

:يلي ام ةدابا ثادحلأا تلاجس ىلع مّيقلا ىلع

 

 

 

 

Each agency, department, or office, upon request, shall notify the 
Court or its designee, in writing, of the action taken in response to 
the order to expunge or destroy. 

 اًيباتك ،ةمكحملا هتنيع نم وا ةمكحملا غيلبت ،بلطلا دنع ،بتكم وأ مسق وأ ةلاكو لك ىلع
.ريمدتلا وأ بطشلا رملأ ةباجتساك اهذاختا مت يتلا تاءارجلااب
 

 

he school building principal or his or her designee is directed to 

destroy the information received from the court pursuant to 
Pa.R.J.C.P. 163. 
 

AOPC Rev. 7/1/2019 
Order Granting Motion for Expungement (English/Arabic)-Translated on 6/21/2021 
 

 نم ةسردملا اهتقلت تامولعم يأ ريمدت ةسردملا ريدم هنيع يذلا صخشلا وأ ةسردملا ريدم ىلع
 بجومب ةمكحملا

. 
 
Pa.R.J.C.P. 163

     

         

         

         

           

  T

In the Interest of:  

 

رصاق ،
 

, a Minor 

 
:
ةحلصمل

IN THE JUVENILE COURT OF   
COUNTY, PENNSYLVANIA 

                 

The information required under Rule Pa.R.J.C.P. 172 appears on 
the attached page(s) which is hereby incorporated into this 
ORDER by reference. 
 
 
BY THE COURT: 

 

 

_________________________________________ 
 
Judge 
ق 
ا
ض
 
 

Rule Pa.R.J.C.P. 172
 تاحفصلا/ةحفصلا يف ةنيبم
 
 
 
 
  .ةراشلااب
 

 بجومب ةبولطملا تامولعملا
رملأا
 اذه يف ةجردمو ةقفرملا

 

:ةمكحملا لبق نم

AOPC Rev. 7/1/2019 
Order Granting Motion for Expungement (English/Arabic)-Translated on 6/21/2021 
 

     

                                                                                     

In the Interest of:  
،
 
ا
ق
ص
 
 

 

, a Minor 
 
:
ةحلصمل

Expungement Order - Juvenile  

بطش رارق
  ثدح
-
 
 

 

Docket No:   
 
ةظفاحلا مقر
 

 
         

 

 

 

 

1. Name of Juvenile: ___________________________________ 
 
2. Alias(es): ___________________________________ 
 
3. Date of Birth of Juvenile if known: ________________________ 
 
4. The juvenile's case docket number, if any:__________________ 
 
5. The allegations or offenses to which the expungement order 
pertains: 

 

 

___________________________________
 

:ثدحلا مسا
 

1. 

___________________________________
 

:ىرخأ ءامسأ
 

2. 

 

________________________
 

:)اًمولعم ناك اذإ( ثدحلا ةدلاو خيرات
 

3. 

 

__________________
 

 

:دجو نإ ،ثدحلا ةيضق ةظفاح مقر

4. 

 

 :بطشلا رمأب ةصاخلا مئارجلا وا تاءاعدلاا
 

5. 

Statute 
 نوناقلا

  

            

                    
 
 

Grade 
    
ةجردلا
 
 
 
 
 

Description 
فصولا
 
 
 
 
 
 

                                                                    

Disposition 
سحلا
م

 

 

6. The law enforcement agency that initiated the allegations: 
___________________________________ 
 
7. The reference number of the police report or written allegation to 
be expunged or destroyed, including the juvenile offense tracking 
number (JOTN) if available: 
___________________________________ 

8. The date of arrest: ___________________________________ 
 

9. The reasons and statutory authority for expunging or destroying 
the documents, fingerprints, or photographs: 
 

 

6. 
___________________________________
 

:تاءاعدلاا يف تعرش يتلا نوناقلا ذافنإ ةلاكو
 

 ،اهتدابا وأ اهبطش بولطملا ةيباتكلا تاءاعدلإا وأ ةطرشلا ريرقتب صاخلا يعجرملا مقرلا

7. 
( ثدحلا ةحنج عبتت مقر كلذ يف امب
___________________________________
 

:رفوت نإ ،

JOTN)

 

 

 

 

___________________________________
 

 

:لاقتعلاا خيرات

8. 

:ةيفارغوتوفلا روصلا وأ تامصبلا

 وأ تادنتسملا ةدابإ وأ بطشل ةينوناقلا ةطلسلاو بابسلأا

9. 

0. The agencies upon which certified copies of the court order 
shall be served: 

 

:ةمكحملا رمأ نم ةدمتعُم خسن اهميلست بجي يتلا تلااكولا
 

10. 

 

 

 

 

 

 
 

     

       

   

         

 

 

        1

         

 

AOPC Rev. 7/1/2019 
Order Granting Motion for Expungement (English/Arabic)-Translated on 6/21/2021