Kenneth Vercammen is author of the ABA "Criminal Law Forms" book.
More info at
Kenneth Vercammen & Associates, P.C.
2053 Woodbridge Avenue - Edison, NJ 08817

Saturday, July 1, 2017

Special Child Power of Attorney to Permit a family Member to care for a minor child NJ Statute 3B:12-39 Delegation of parents or guardians powers regarding care, custody & property of children

Special Child Power of Attorney to Permit a family Member to care for a minor child
     NJ Statute 3B:12-39 Delegation of parents or guardians powers regarding care, custody & property of children

       A parent, other than where custody of a minor has been awarded by a court of competent jurisdiction, with the consent of the other parent, if the latter is living and not an incapacitated person or a guardian of the person of a minor or an incapacitated person, by a properly executed power of attorney, may delegate to another person, for a period not exceeding six months, any of his powers regarding care, custody, or property of the minor child or ward, except his power to consent to marriage or adoption of a minor ward.

Commonly Asked Questions
1)  What is a Child Power of Attorney?
A Power of Attorney is a document that allows you to give someone else the authority to care for and make decisions about your child or children.
2)  Do I need to complete a separate form for each of my children?
3)  In the Power of Attorney, what is the person who would get the authority to care for my child or children called?
An “Attorney in Fact”
4)  Does the “Attorney in Fact” have to be an attorney? Does the “Attorney in Fact” have to be a person with some legal immigration status?
NO – An “Attorney in Fact” does not have to be an attorney. You can appoint any adult (18 years of age or over) who you trust and with whom your child/ren would feel comfortable. It is preferable if you appoint someone with legal immigration status, but it is not necessary.
5)  What can an “Attorney in Fact” do?
The Power of Attorney allows you to give someone else the authority to do the following: (1) care for and provide for your child, (2) make medical and educational decisions, (3) approve and arrange for travel plans, (4) and handle any financial matters in which your child may be involved.
You can specify which of these authorities you wish to delegate. You can check only some or you can check all of them. However, if you want the person to be able to fully care for your child if you are not able to do so, then you should check off all of the specific authorities.
6)  Does the Power of Attorney have to be signed by both parents?
The Power of Attorney is best when signed by both parents. However, if that is not possible, you should still complete the form to the best of your ability. The form includes a section where one parent can explain why the other is not signing.

7)  Does the Power of Attorney have to be witnessed?
In order to ensure the validity of the Power of Attorney, it should be witnessed by two people. These people do not have to have any immigration status, but they should be over 18 years old. However, if you cannot find any adult to witness your signature, or can only find one adult, you should still complete the form to the best of your ability. The person you use to notarize the document cannot also be a witness.
8)  Does the Power of Attorney have to be notarized?
In order to ensure the validity of the Power of Attorney, it should be signed in front of an Attorney or notary
9)  Does the Attorney in Fact need to sign the Power of Attorney?
10)  Can someone other than a parent initiate a Power of Attorney?
YES – A person who has legal guardianship can enter into a Power of Attorney, and a person who has legal custody (as opposed to legal guardianship) may also be able to do so. You should complete the form if you are concerned about who will care for the child/ren in your care if you are unable to do so.
For how long is the Power of Attorney in place?
The Power of Attorney is only good for 6 months, but you can complete
more than one.
 Do I lose my authority as a parent if I enter into a Power of Attorney?
NO – While a Power of Attorney is in place, both the parent(s) and the “Attorney in Fact” can make decisions on behalf of the child.
 How can I end a Power of Attorney?
You can end (“revoke”) the Power of attorney at any time. To revoke, you simply put in writing that you are revoking the Power of Attorney. It is best if the revocation is witnessed and notarized just like the Power of Attorney, but this is not necessary.
 Once a Power of Attorney form is finalized, who should keep the original document?
The Attorney in Fact should keep the original notarized document and the parent should keep a copy. It may also be useful to give copies to the children and/or other close family friends or relatives.
 Will the Power of Attorney keep DCPP (child welfare officials) from taking custody of my child?
The Power of Attorney shows that you made a plan for someone else to care for your child if you could not. However, if DCPP has concerns about the welfare of your child, it may still act to protect the child.
 Is this Power of Attorney good in other states?
NO – This power of attorney is only good for New Jersey. Do not share it with family members in other states. If you have family members outside of New Jersey, they should look for similar documents in their home state.

I/we appoint said attorney in fact, pursuant to the provisions of N.J.S.A. 3B:12-39, and delegate to said attorney in fact the following powers concerning the care, custody and property of my/our child
________________________________________________________________________(“the child”), born on __________ day of _______________________, 20____.
____ Care-Giving. The attorney in fact shall have temporary care-giving authority for the child, until such time as the child is returned to our/my physical custody, or his/her custody status is altered by a federal, state, or local agency; or changed by a court of law.
____ Well-Being. The attorney in fact shall have the power to provide for the child’s physical and mental well-being, including but not limited to providing food and shelter.
____ Education. The attorney in fact shall have the authority to enroll the child in the appropriate education institutions; obtain access to the child’s academic records; authorize the child’s participation in school activities; and make any and all decisions related to the child’s education, including, but not limited to, those related to special education.
If the first three authorities are checked this shall mean that the child’s parent/guardian is not capable of supporting or providing care for the child due to family or economic hardship.
____ Health Care. The attorney in fact shall have the authority, to the same extent that a parent would have the authority, to make medical, dental, and mental health decisions; to sign documents, waivers and releases required by a hospital or physician; to access medical, dental, or mental health records concerning the child; to authorize the child’s admission to or discharge from any hospital or medical care facility; to consult with any provider of health care; to consent to the provision, withholding, modification or withdrawal of any health care procedure; and to make other decisions related to the child’s health care needs.
_____ Travel. The attorney in fact shall have the authority to make travel arrangements on behalf of the child for destinations both inside and outside of the United States by air and/or ground transportation; to accompany the child on any such trips; and to make any and all related arrangements on behalf of the child, including but not limited to, hotel accommodations.
_____Financial Interests. The attorney in fact may handle any and all financial affairs and any and all personal and legal matters concerning the child.
_____ All Other Powers. The attorney in fact shall have the authority to handle and engage in any and all other matters relating to the care, custody and property of the child which are permitted pursuant to applicable state law.
Either parent/guardian reserves the right to revoke this Power of Attorney at any time.
Signatures of Parent(s)
______________________________________________ Signature of Mother
______________________________________________ Signature of Father
______________________________________________ Signature of Guardian
____________________________________________ Date signed by Mother
_____________________________________________ Date signed by Father
_____________________________________________ Date signed by Guardian

source at

Monday, June 19, 2017


In this juvenile delinquency prosecution, the Family Part sua sponte transferred venue to another vicinage without notice to the juvenile defendant or the State. When the State objected, the judge held a hearing and stated the transfer was occasioned by receipt of a confidential report filed by an judiciary employee pursuant to Judiciary Employee Policy #5-15, "Reporting Involvement in Litigation," (effective June 1, 2016) (the Policy). In a subsequently filed brief statement of reasons, without identifying the employee or his or her relationship to the litigation, the judge concluded that given the employee's access to the Family Automated Case Tracking System (FACTS), location in the courthouse and interaction with the public, the Policy required the transfer of venue.
The court granted the juvenile's motion for leave to appeal, which the State supported, and reversed. Our Court Rules presume venue is laid in the county of the juvenile's domicile, a presumption further supported by provisions of the Code of Juvenile Justice. Additionally, the Crime Victim's Bill of Rights require the court to consider the inconvenience to the victim occasioned by the transfer of venue.
While the Family Part Presiding Judge may order the transfer of venue for good cause over the objections of the juvenile and the State, the court must provide notice of its intention and an opportunity to object beforehand. Additionally, the court's power must be exercised in service to the goals of the Policy, i.e., "to maintain [the Judiciary's] high degree of integrity and to avoid any actual, potential or appearance of partiality or conflict of interest in the adjudication or handling of all cases," and the court must consider whether a less drastic measure, such as "insulating the [court employee] from the matter," would accomplish these goals

Thursday, February 23, 2017

Municipal prosecutors advised not to reduce traffic tickets to no point violations for teen drivers

Municipal prosecutors advised not to reduce traffic tickets to no point violations for teen drivers

  This does not prohibit a hiring an attorney to plea bargain or have a trial to reduce to two point violations or for more serious violations. Hiring a good trial attorney will usually cost more than $500.
Inexperienced young attorneys sometimes charge less.

Attorney General Directs No Plea Bargains for Teen Drivers 2008
Trenton, NJ – Following a key recommendation of the Teen Drivers Study Commission, Attorney General Anne Milgram has directed municipal prosecutors not to offer or accept plea bargains to teen drivers with Graduated Drivers’ Licenses for motor vehicle violations that carry points.
The directive is aimed at ensuring that new drivers participate in driver improvement programs that are mandatory for young drivers who accumulate three or more points. The directive specifically bars pleas to a violation of operating a motor vehicle in an unsafe manner, a plea that avoids the assessment of points.
The Teen Drivers Study Commission recommended the action because a provision of the Graduated Drivers License system had been undermined by plea offers to no-point offenses.
“It is necessary for prosecutors to differentiate GDL holders from regular licensees when determining an appropriate plea offer,” Milgram wrote in a memorandum sent to all municipal and county prosecutors on Wednesday. “GDL holders are probationary drivers and it is entirely appropriate that they be held strictly accountable for all motor vehicle violations.’’
A GDL holder who is charged with a motor vehicle violation does not have a sustained record of safe and lawful driving, which is an important factor that prosecutors consider when determining negotiated resolution of charges. Therefore, pleading motor vehicle violations to no-point offenses allows GDL drivers to escape remedial measures and leaves high-risk and inexperienced drivers on the road.
“The need to deter and remediate driving offenses is greater with respect to new, young drivers,’’ Milgram said.
Pam Fischer, the director of the Division of Highway Traffic Safety and the chairwoman of the Teen Driver Study Commission, said, “This directive represents a significant step forward in our efforts to ensure that teen drivers are not only kept safe and free from harm behind the wheel, but when they do violate motor vehicle laws, they are properly sanctioned and receive training that will protect them in the future. We now have a way to effectively identify teens that have demonstrated unsafe driving behaviors and address them before they result in tragedy on our roadways.
“One of 14 priority recommendations made by the Division, the directive is a major step forward for safety. The Commission thanks the Attorney General for her commitment to teen driver safety and looks forward to continuing to work closely with her, the Governor’s Office, and the Legislature as we move forward with the Commission’s recommendations to help reduce crashes and save lives.”
A copy of the directive and the full Teen Driver Study Commission report is available on line at
View directive - 115k pdf

See also

Sunday, February 19, 2017


ERASE/ EXPUNGEMENT OF ARRESTS AND CONVICTIONS TO AVOID EMBARRASSMENT AND DISCLOSURE                                                                 

          If someone has been arrested or even had a private criminal complaint signed against them in the Municipal Court, they have a criminal record, even if the charges were dismissed.         This is an excellent law to help non-violent offenders. Don’t be denied a job, credit or barred from coaching based on an old criminal charge.
         Under NJSA 2C:52-1 et seq. past criminal arrests and convictions can be expunged/ erased under certain instances. We always recommend individuals hire an attorney to obtain an expungement. The process for all expungements are held in the Superior Court. It takes a minimum of three months for the court to grant the expungement.  The requirements are very formal. There can be a waiting period between 6 months up to 10 years after the criminal cases is finished. More info at
         1. Obtain a certified disposition from the Court
         If the case was heard in Municipal Court, we recommend you obtain a "certified disposition" of the court's decision, from the Court itself. This is expedite the process. In Superior Court, obtain Order of Dismissal or Order of Conviction. Court costs and Legal fees for expungement range from $1,500-  $2,500.
         Thousands of citizens over the past 30 years have been arrested for criminal, disorderly, and municipal ordinance offenses.  The courts and police must keep a record of all arrests and convictions, even if 30 years old.  Judgements of Conviction are public records. These "secrets of the past" could be open to anyone including credit agencies.  Under one proposal, for a $15.00 fee, someone could ask the state police for a person's criminal record, even arrests with not guilty findings.  Allowing access to a person's old criminal conviction or arrest record could open the door for discrimination or job loss against someone who now is a productive, respected, and law abiding citizen. Many employers often do a criminal background check on new and promoted employees.
       Fortunately, if you are a law abiding citizen, you can now have old arrests or most convictions erased from public records and police folders. Under NJSA 2C:52-1 et seq. past criminal arrests and convictions can be expunged/ erased under certain instances. 
       2. Waiting periods
         If you were convicted or pleaded guilty to a disorderly person offense (misdemeanor type) more than 5 years ago, and have not been convicted of anything since, you can have your attorney petition to the Superior Court for an Expungement (Erase and removal) of your criminal record.  The waiting period starts from the full payment of fines, completion of probation or other requirements, whichever finishes latest.
         If you plead guilty to a town ordinance (ex. - Seaside Heights Drinking in Public) you can petition for an Expungement after waiting two years.  A Juvenile delinquent/guilty finding for a minor can also be expunged/erased under similar circumstances.  In addition, minor drug arrests which resulted in first offender conditional discharge can be erased after 6 months has passed since termination of probation or conclusion of court proceedings.
     Most importantly, arrests on frivolous complaints which did not result in a conviction or if charges were dismissed, can be expunged, without waiting.
         The waiting period on an indictable charge [guilty plea in Superior Court] is 10 years. [There is a new hardship provision to apply for expungement 5 years after probation is up. Speak with an experienced attorney]
The Chart below is helpful:
            Expungement eligibility NJ

Type of Offense
Waiting Period
Indictable Offenses
1 conviction, plus up to 2 Disorderly Persons convictions
10/ years from date supervision completed [or 5 year eagle scout rule]

Disorderly Persons Offenses (includes Petty DO Offenses)

Up to 2 offenses, provided no other criminal convictions
5 years from court date & fines paid [or 3 year eagle scout rule]

Municipal Ordinance Violations
ex: Seaside Park fighting etc
No limit, provided no criminal record and no more than 2 Disorderly Persons convictions

2 years from court date & fines paid
Juvenile Delinquency Offenses

All records, except those that are of the 17 ineligible offenses committed by an adult
5 years from date supervision completed
Young Drug Offender Records

No limit if for possession or use of CDS
1 year from date supervision completed
Arrests - No Conviction, charge dismissed 2C:52-6

No Limit
No waiting period

For PTI, Conditional Discharge or Conditional Dismissal - 6 months from completion of program 2C:52-6 (c)

More info at
         3. Common criminal offenses to get expunged
         The following criminal offenses are some of the typical
offenses individuals can petition for expungement:
         Alcohol Underage                            2C:33-15
         Arson                                             2C:17-1
         Assault                                           2C:12-1
         Bad Check                                       2C:21-5
         Burglary                                         2C:18-2
         Conspiracy                                      2C:5-2
         Criminal Mischief                             2C:17-3
         Criminal Trespass                           2C:18-3
         Disorderly Conduct                          2C:33-2
         Drug  Paraphernalia                         2C:36-1
         False / Fraud Instrument                2C:21-3
         Harassment                                    2C:33-4
         Hindering Apprehension                   2C:29-3
         Lewdness / Criminal Contact           2C:14-4
         Obstructing Admin. of Law              2C:29-1
         Possession Drugs                            2C:35-10
         Prohibited Weapons                         2C:39-3
         Prostitution                                    2C:34-1
         Receiving Stolen Property               2C:20-7
         Resisting Arrest                             2C:29-2
         Shoplifting                                      2C:20-11
         Stalking                                          2C:12-10
         Terroristic Threats                         2C:12-3
         Theft by Deception                         2C:20-4
         Theft of Services                           2C:20-8
         Theft Unlawful Taking                     2C:20-3
         Wandering                                       2C:33-2.1
         Weapon Unlawful Purpose                2C:39-4

4. Convictions which never can be expunged:
-Most possession with intent to distribute drugs
-DWI and all other traffic offenses
-Family Court restraining orders

1  Criminal Homicide (Except Death by Auto);
2  Kidnapping;
3  Luring or Enticing;
4  Aggravated Sexual Assault;
5  Aggravated Criminal Sexual Contact;
6  Criminal Sexual Contact (if victim is a minor);
7  Criminal Restraint;
8  Robbery ;
9  Endangering the Welfare of a Child (if based on sexual contact);
10          Perjury;
11          False Swearing or perjury;
12          Human Trafficking;
13          Causing or Permitting a Child to Engage in a Prohibited Sexual Act;
14          Selling or Manufacturing Child Pornography;
15          Knowingly Promoting the Prostitution of the Actor's Child;
16          Terrorism; and
17          Producing or Possessing Chemical Weapons, Biological Agents or Nuclear or Radiological Devices.

      See "2C:52-2"c.In the case of conviction for the sale or distribution of a controlled dangerous substance or possession thereof with intent to sell, expungement shall be denied except where the crimes involve:

(1)Marijuana, where the total quantity sold, distributed or possessed with intent to sell was 25 grams or less;

(2)Hashish, where the total quantity sold, distributed or possessed with intent to sell was five grams or less; or

*   (3)Any controlled dangerous substance provided that the conviction is of the third or fourth degree, where the court finds that expungement is consistent with the public interest, giving due consideration to the nature of the offense and the petitioner's character and conduct since conviction.     
           You should contact an attorney experienced with handling expungements.  The Expungement Petition is filed in the county where the offense took place, not where the defendant lives. The petition is filed not in the Municipal Court but in the Superior Court. Once filed, the Superior Court will set a hearing within 35-60 days. Your attorney will prepare an Expungement Petition which under state law must contain substantial background information, including:
         a.  Date of Birth and Social Security #
         b.  Date of Arrest
         c.  Statute Arrested For and Statute Convicted
         d.  Original Indictment, Summons, or Complaint Number
         e.  Petitioner's Date of Conviction or Date of Disposition
         f.  Court's Disposition of the Matter and Punishment Adopted, if Any

         In addition, the Expungement Petition must have an affidavit that states that there are no charges pending and that the petitioner never previously received a prior expungement.
          As required under the statute, the attorney for the applicant must serve a copy of the Petition Order for hearing and supporting documents on the following people:  1.)  Superintendent of State Police  2.)  Attorney General  3.)  County Prosecutor of the county where the court is located  4.)  The Chief of Police where the event took place  5.)  The chief law enforcement officer of any other law enforcement agency which participated in the arrest  6.)  The warden of any institution where the petitioner was confined  7.) the Municipal Court if the disposition was made by a municipal court, 8 County Sheriff
     If you satisfy all other statutory requirements and there is no objection by the entities notified, the court will usually grant an order directing the Clerk of the Court and all relevant criminal justice and law enforcement agencies to expunge (remove) records of said disposition including evidence of arrest, detention, conviction, and proceedings.
     There are additional pleadings which the applicant's attorney must prepare and file.  If you have an old offense, it is important that you have the arrest expunged to keep your name and record clean. All criminal charges, even if dismissed, stay on your record forever, unless the expungement order is granted by a Superior Court Judge.

6. Expungement Services to Apply to Remove/Erase Criminal Arrests and Convictions/ Retainer for Legal Services

 Fee $1,900 if traditional expungement
If Eagle Scout expungement where time period shorter, fees additional
Credit card or Check payable to Vercammen PC.
[Fee is less if we handled case previously]

Also you need to provide a separate check or money order for court fees:
 -Check for $75.00 payable, Treasurer, State of NJ
-Check payable  Postmaster Edison $70.00 for certified mail
These fees cannot be paid by credit card.

7. What the Attorney will do:
-Telephone consultation with client;
-Office consultation with client if requested;
-Opening of file and client may have free client case folder, Municipal Court brochure, MVC Points brochure, and Website brochure;
-Review documents supplied by client and court;
-Review of necessary statutes and case law;
         - Preparation of ORDER FOR HEARING FOR EXPUNGEMENT PURSUANT to N.J.S.A. 2C:52-6(a)
         - Preparation of proposed ORDER FOR EXPUNGEMENT

Prepare letter to Client with Petition, Statement to Accompany Petition of no pending charges, Order for Hearing, Proposed Order for Expungement

Client signs Petition Statement to Accompany Petition of no pending charges

Attorney calls Superior Court and confirm address for Expungement Unit.

We Mail to Superior Court Expungement Unit-
                           Orig. and one Petition
                           Statement to Accompany Petition
                           Order for Hearing
                           Proposed Order for Expungement
                           2 self-addressed stamped envelopes
Follow up Court Order for hearing (takes approx 30 days)

         Upon receipt of signed Order for hearing, Prepare Certified Mail Green cards for documents to be served on law  enforcement and court. -
-Preparation of letter with Order for hearing and proposed Order for Expungement to NJ Attorney General
                       Department of Law & Public Safety
                       Expungement Section- PO Box 080
                       Trenton, NJ 08625  
         - Preparation of letter with Order for hearing and proposed Order for Expungement to NJ Superintendent of State Police
                  Expungement Unit
                  River Road, PO Box 7068
                  West Trenton, NJ 08628
         - Preparation of letter with Order for hearing and proposed Order for Expungement to County Prosecutor;
         - Preparation of letter with Order for hearing and proposed Order for Expungement to Chief of Police;
         - Preparation of letter to client with Order for hearing and proposed     Order for Expungement to Municipal Court Administrator;
         When all the green cert. mail cards come in we put date mailed to Law Enforcement. on form 6 (Cert.) and mail to Court . After receipt of all certified mail Green cards, Preparation of CERTIFICATION OF SERVICE OF ORDER FOR HEARING
         We make copies of cert. mail green cards and letter before mailing out original green cards to court.
Misc phone calls to and from client
-Call Superior Court Expungement Unit to confirm they received green cards and no need to appear on hearing date if no objection.

If Expungement granted and receipt of signed Order for Expungement,
         Preparation of letter with signed Order for Expungement to:
         -NJ Attorney General by regular mail
                          Department of Law & Public Safety
         - Preparation of letter with signed Order for Expungement to
         NJ Superintendent of State Police
         - Preparation of letter with signed Order for Expungement to County    Prosecutor;
         - Preparation of letter with signed Order for Expungement to Chief of Police;
         - Preparation of letter with signed Order for Expungement to Municipal Court Administrator; and any other public entity requested by the court. Please note a Judicial Expungement granted by the Superior Court Judge does not change databases set up by private entities or credit agencies.
Preparation of End of Case Letter to client with original signed Order for Expungement and client questionnaire.

         Please note we do not open a file and do not handle the case until all fees are paid in full up front.
Any other work not listed above will require additional fees or costs.
 The client must provide disposition or copies of complaint for all prior Municipal court criminal charges, even criminal charges you were not arrested or fingerprinted. This is required by the Superior Court. All charges since you were 18 years old must be listed.
8. Obtaining a criminal History
You may want to order a criminal history CCH on yourself when the expungement is started if you are not 100% sure of your prior charges in NJ and the USA. The fee to obtain your criminal history is less than $75. For a Criminal History Contact or call Morpho Trak at 1-877-503-5981. The law office cannot obtain a criminal history. Our Private investigator can do obtain a criminal history for you for an extra $900.
If the expungement is granted we recommend to all clients to send a follow up letter and copy of Order for Expungement by Certified Mail to all above Courts and Law Enforcement so they have a copy for their records. The Law Office can handle this for additional fee of $250. You should also serve a copy on the credit reporting agencies.
If the Court grants the expungement petition, the NJ police departments and NJ courts will be required to remove information from their records. The Court order does not pertain to online private companies or websites, which may contain old information. The Federal Government and immigration still has access to expunged /erased records.
If there are objections to the Expungement Petition by the Prosecutor or other entities and a hearing is required, additional fees will apply. They fee you paid does not include appeals if the court denies your petition.

 9 To Start the process- Interview Form
Please fill out blank lines on your computer or by hand and email or return to office to start Expungement, and provide check or credit card info. You need to provide us with the Certified disposition if your prior offense was in Municipal Court. The Certified disposition should be provided to the Superior Court. To obtain the certified disposition, simply contact the Municipal Court. They will charge a fee of approx $10.00.
  If you are unable or unwilling to do this, our fee to drive to the court to obtain the Certified disposition is an additional $300.
If your prior charge was in Superior Court, provide the Order of Dismissal if dismissed, or Judgment of Conviction JOC if a guilty plea.
If PTI Pre-trial intervention, provide copy of Order of Dismissal.

The court-filing fee is requires a separate check. $75.00 payable, Treasurer, State of NJ
Check payable  Postmaster Edison $70.00 for certified mail

1.    Petitioner's name is _____________. 
any other name used___________________.
Current address ___________________________________
CITY _____________________________ STATE _______ ZIP __________

CELL-PHONE ___________________________________ (Area Code Needed)
OTHER PHONE-DAY __________________________ 

E-MAIL ADDRESS ______________________________________________

REFERRED BY: _______________________________________________

2.  Petitioner's date of birth is _______, Social Security Number is ________

3.  Petitioner was charged  on   ________________ for violation of the following:  
N.J.S.A. 2C:  ______________

type of offense   _________________

Town ___________________

Summons/ Warrant/ Complaint #  ____________________
[Leave out traffic tickets ex 39:4-49.1.   Traffic tickets cannot be expunged]
The original complaint number was ___________

4.  This matter was in ___________   County  . 

5. This matter was heard in the   ______________ Municipal Court on __________

6. On ______, I plead guilty of the following offense: ________________________.
I was fined _____, costs of ______ and ______.


on ________________, charges were dismissed

7. The following are all other charges against me since I was 18 year old, even if the charge was dismissed:  [IF NONE, WRITE NONE]
Petitioner was charged  on   ________________ for violation of the following: 
N.J.S.A. 2C:  ______________

type of offense   _________________
Summons/ Warrant/ Complaint #  ____________________

Other prior offenses:
This matter was in ___________  County , town ______________

Disposition/ result ___________________________________
[If none, write none]

The client must provide a written disposition to the court for all prior criminal charges, even criminal charges you were not arrested or fingerprinted. This is required by the Superior Court. All charges since you were 18 years old. The Law Office can obtain the a Certified Disposition for Municipal Court cases, or a Judgment of Conviction for Superior Court charges at a fee of $400 per court. It is usually more cost effective for the client to obtain the court records themselves.
Email interview form back to

Details on expungement at