Insert Attorney or Name Petitioner’s Insert Bar # (If Attorney) Insert Street Address Insert City, State & Zip Code Insert Telephone Number Insert Name of Township JUSTICE COURT CLARK COUNTY, NEVADA In the Matter of the Application of, Insert Name, Petitioner’s CASE NO: LVMPD CS# or ID#: Insert CS# or ID# DEPT NO: Date of Birth For an Order to Seal Records ORDER TO SEAL RECORDS Pursuant to the Petition of Petitioner, represented by Insert Name, Insert Petitioner’s name if applicable or name if not represented by counsel, and attorney’s petitioner’s Steven B. Wolfson, District Attorney for Clark County, Nevada, having stipulated below, the Court finding that the statutory requirements of NRS 179.245, 179.255, 176A.265, 179.259, 179.285 and/or 453.3365 are satisfied, and good cause appearing, therefore IT IS HEREBY ORDERED that the following records of arrest be sealed: PLEASE BEGIN WITH YOUR MOST RECENT ARREST (refer to your SCOPE or CRIMINAL HISTORY REPORT) Date of Arrest: Insert date of arrest Arresting Agency: Insert arresting agency Case Number: Insert case number Court Where Charges Were Handled: Insert court name Charge: Insert charge
Insert Attorney or Petitioner’s Name Insert Bar # (If Attorney) Insert Street Address Insert City, State & Zip Code Insert Telephone Number Insert Name of Township JUSTICE COURT CLARK COUNTY, NEVADA In the Matter of the Application of, Insert Petitioner’s Name, LVMPD CS# or ID#: Insert CS# or ID# Date of Birth For an Order to Seal Records CASE NO: DEPT NO: ORDER TO SEAL RECORDS Pursuant to the Petition of Insert Petitioner’s Name, Petitioner, represented by Insert attorney’s name if applicable or petitioner’s name if not represented by counsel, and Steven B. Wolfson, District Attorney for Clark County, Nevada, having stipulated below, the Court finding that the statutory requirements of NRS 179.245, 179.255, 176A.265, 179.259, 179.285 and/or 453.3365 are satisfied, and good cause appearing, therefore IT IS HEREBY ORDERED that the following records of arrest be sealed: PLEASE BEGIN WITH YOUR MOST RECENT ARREST (refer to your SCOPE or CRIMINAL HISTORY REPORT) Date of Arrest: Insert date of arrest Arresting Agency: Insert arresting agency Case Number: Insert case number Court Where Charges Were Handled: Insert court name Charge: Insert charge