Request To Seal Decriminalized Offense(S)

Name:   Enter Name
   
Address:   Enter Address   

City, State, Zip:   Enter City, State, Zip      

Phone:   Enter Phone Number   

Email:   Enter Email   

Defendant Name   

Defendant Date Of Birth   

The above-named defendant hereby requests that the Court order the following criminal cases be sealed pursuant to NRS 179. If no written objection to the request is filed within ten judicial days after the date which notice of the request is received the court shall grant the request. If a written objection to the request is filed,the court will hold a hearing on the request.

Enter Case Number 1   Enter Offense/Charge 1   Conviction Date 1  

Enter Case Number 2   Enter Offense/Charge 2   Conviction Date 2   

Enter Case Number 3   Enter Offense/Charge 3   Conviction Date 3   

Enter Case Number 4   Enter Offense/Charge 4   Conviction Date 4   

Date   Signature