Pardon Project Intake

Pardon Project Intake

Answering these questions will help us get back to you with the information you want!
Name*

First NameLast Name
Email*
example@example.com
What kinds of problems has your criminal history record caused you? Why would erasing your record help you? This information is important for getting a pardon. *
In what PA county do you currently live?*
If you live out-of-state, enter N/A
In what counties in PA were you convicted?*
We can only help with convictions in Pennsylvania state courts.
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter the best number to reach youFormat: (000) 000-0000.
is this a cell phone?*

YesNo
When are the best days and times to talk with you?*
Can you receive text messages?*

YesNo
Back-up contact person's name:*
Who can we contact if we cannot reach you?
Back-up Phone Number*
For your back-up contact person .Format: (000) 000-0000.
How many convictions in PA do you have?*
NOTE: We can ONLY help with convictions in PA
When did you complete your (most recent) sentence?*

Within the past 5 yearsMore than 5 years agoMore than 10 years agoHaven't yet completed it
Did your crime (or any of them) involve the use of drugs or alcohol?*

YesNo
Did your crime (or any of them) involve violence, or the threat of violence, to another person?*

Yes, to an adultYes, to a childNo
Have you been ordered to pay restitution to a victim of your crime(s)?*

YesNo
Have you been convicted of any crime in any other jurisdiction (state or federal)?*

YesNo
If "yes", what was/were your out-of-state conviction(s) for?*
Since we work only in PA, we cannot help you erase these, but we need to know what they are.
Where do you currently live?*

Street Address

Building Name, Unit or Apartment Number

CityState

Zip Code
Do you own or rent the place where you currently live?*

RentOwnOther
How many other people (total) depend on you and your income / are part of your household?*
Of the total you just gave, how many are children under 18?*
Are you currently employed*

Yes, I work for someone elseYes, I am self-employedNot currently
For how long have you been working for that employer, or been unemployed?*
Our Pardon Project will help you for free if you don't make enough money to pay for a lawyer. Are you looking for free assistance with your pardon application?*

Yes. Please answer the next questions. If you don't have exact answers, do your best.No. You can skip the rest of the questions.
Please tell us the AMOUNT and SOURCE of any money you make or receive every week or month. (Be sure to include things like wages from work, social security, worker's comp, insurance, alimony, child support, SNAP/food stamps, etc.):
We provide free help for low-income individuals. If you do not qualify for free service, we can help you find someone to help that may charge you less because your income is above our line.
Does anyone who lives with you receive money that goes to supporting your family/household? If so, tell us the AMOUNT and NAME OF THE PERSON contributing that money.
Be sure to say whether this is per week or per month
Please tell us the AMOUNT and REASON of any major debts or expenses you have to pay.
Be sure to say whether this is per week or per month, or a total you owe.
File Upload - For Later Use - Pardon Application Documents

This will help us keep a copy of your Pardon Application when it's done and any other documents you submit.
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