Verified Petition For Nondisclosure (Confinement Or Unsuccessful Probation)

NO. __________________________

STATE OF TEXAS § IN THE ________ COURT

§

vs. § OF

§

_________________ § ____________ COUNTY, TEXAS

VERIFIED PETITION FOR NONDISCLOSURE

TO THE HONORABLE JUDGE OF SAID COURT:

___________________, Petitioner, moves this Court for an Order of Nondisclosure under Section 411.0736 of the Texas Government Code and would show the Court as follows:

Petitioner’s information:

NAME: ___________________

SEX: _______________

RACE: _______________

DATE OF BIRTH: _______________

DRIVER’S LICENSE NUMBER: Texas _______________

SOCIAL SECURITY NUMBER: _______________

Offense that is the subject of this Petition:

OFFENSE: Driving While Intoxicated under .15

DATE OF OFFENSE: on or about _______________

DATE OF ARREST: on or about _______________

COUNTY WHERE ARRESTED: ____________

ARRESTING AGENCY: _______________

CASE NUMBER: _______________

COURT: _______________

TRN: ______________

Petitioner is eligible for the requested Order because the offense for which Petitioner was convicted was a

misdemeanor under Tex. Penal Code §49.04, but not an offense punishable under subsection (d) of that section.

NOTE: PICK ONE of the FOLLOWING 2 PARAGRAPHS

Petitioner is eligible for the requested Order because at least three years has passed since Petitioner complete his/her term of confinement under the sentence on ____________________, (or was unsuccessfully discharged from probation) and Petitioner successfully complied with a term of his/her sentence requiring his/her vehicle to be equipped with an ignition interlock device for a period of at least six months. (See Exhibits ____).

—OR—

Petitioner is eligible for the requested Order because at least five years has passed since Petitioner completed his sentence of confinement (or was unsuccessfully discharged from probation) on__________________. (See Exhibit ____).

During the period described above, Petitioner has not been convicted of or placed on deferred adjudication community supervision under Section 5, Article 42.12, Code of Criminal Procedure, for any offense other than an offense under the Transportation Code punishable by fine only. Petitioner has not been placed on deferred adjudication community supervision for or has not been previously

convicted or placed on any other deferred adjudication for:

1. an offense requiring registration as a sex offender under Chapter 62, Code of Criminal Procedure;

2. an offense under Section 20.04, Penal Code...