Oct 4 2025/ICC NEWARK/ASCEND

OCTOBER 4, 2025 @ DOWN BOTTOM FARMS

NEWARK, NJ

11AM-2PM

This does not constitute an "attorney-client" relationship.

This is pro se e-filing assistance only.

• The information you enter in this form will be used to assist you in preparing your own pro se expungement petition that you will file yourself through the NJ Court's electronic system.

• You are filing pro se (representing yourself). Our role is limited to providing administrative assistance with the electronic filing process and reviewing publicly available court records to help you complete the required forms.

• We do not provide legal advice regarding eligibility or strategy. You are responsible for determining your own eligibility for expungement under New Jersey law. Resources for self-assessment of eligibility are available through the NJ Courts website.

• We do not have access to your complete FBI Criminal History. You are responsible for providing complete and accurate information about all charges anywhere (domestic or foreign). Incomplete information may result in petition denial.

• You are permitting us to access publicly available court records to assist you in completing the petition forms, but you remain responsible for the accuracy and completeness of all information.

• We will provide technical assistance with the NJ Court's Electronic Expungement Portal to help you file your own petition.

• You must maintain good contact information and cooperate in the process, as you are the petitioner filing pro se.

• No guarantee of success is made. We may decline to provide filing assistance to any applicant for any reason. Pending charges or previous expungement filings may affect eligibility.

• Outstanding financial obligations may convert to judgments - consult the court or legal counsel regarding any financial obligations.

• Post-expungement offenses may result in "unexpungement" of records.

• This service is limited to initial petition filing assistance only. We do not provide representation for objections, appeals, or court appearances. For such services, you must retain separate legal counsel.

• You waive and hold harmless all sponsors, agents, volunteers, and involved parties related to this pro se filing assistance.

You agree to (a) be photographed, filmed, and/or otherwise recorded (“Recording”); and (b) the publication, exhibition, modification, or reproduction of the Recording, your appearance, voice, and name for any purpose whatsoever in perpetuity in connection with Blaze Responsibly LLC, including, by way of example only, use on social media, and promotional materials. By entering the event, you waive and release any claims you may have related to the use of the Recording, including, without limitation, any right to inspect or approve the Recording, any claims for invasion of privacy, violation of the right of publicity, defamation, or copyright infringement, or for any fees for use of such Recording. You understand that all Recording will be done in reliance on this agreement.

If you do not agree to the foregoing, please do not attend or enter the event.

Name*

First NameMiddle NameLast NameSuffix

Include any maiden name or aliases: enter here

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Date of Birth*

Date

Please Check Any That Apply to You:

Previously Filed for ExpungementConvicted of an "Indictable" OffenseBeen on Parole, Probation or Court related Supervision in the past 5 yearsName Legally Changed, including by MarriageHave Outstanding Fines or Obligations to any CourtUndocumented Individual

Please Check if You Have Been Convicted of Any Offense Below:

To the best of your knowledge, what were you charged with and where did the offense(s) occur, and what were the outcome(s)? If you do not recall, the Attorney(s) will do their best to look up this information.

Please Answer

Do you have outstanding court fines that you need financial assistance with?

YesNo

Signature*

PLEASE READ FULLY AND COMPLETE BEFORE ATTENDING:

The limited scope of this Agreement is for Blaze Responsibly LLC and its agents to help the Applicant ("You") with the preparation of a petition for expungement in the State of New Jersey.

Thank you for completing this Intake Form. By signing below and clicking "Submit" you agree to the terms listed above and permit Blaze Responsibly and its agents to look up your court records in NJ in an attempt to prepare and submit an expungement petition on your behalf.