Virginia Record Seal — Attorney Referral

Referring Attorney Information

Your Name *

VSB Bar Number

Firm Name *

Your Phone *

Your Email *

Client Information

The fields below ask about your client, not you.

Client's Full Legal Name *

Date of Birth *

Phone Number *

Email Address *

Client's County/City of Residence *

The Charge Your Client Wants Sealed

Describe the charge *

Virginia Code section, if you know it

County/City where charged *

What was the outcome? *

Convicted / found guilty Deferred and dismissed (a program completed instead of trial) Case dismissed (not deferred) Prosecutor dropped it (nolle prosequi) Found not guilty

Was it charged as a felony or misdemeanor? *

Misdemeanor Felony Not sure

Felony class, if you know it

Was this a larceny/theft charge?

Yes No

Date of the offense *

Date convicted / case closed *

Date released from jail or finished probation, if this applies

Was restitution (repayment) ordered in this case?

Yes No

Has it been paid in full?

Yes No

Was this offense drug or alcohol related?

Yes No

Has your client gotten help since then, like treatment or counseling?

Yes Not yet / not sure

Client's Broader Record

Does your client have any other criminal convictions besides the one above? *

Yes No

Briefly describe the other conviction(s)

Please include all of them. This does not disqualify your client. It just means an attorney will look at the case personally.

Has your client already filed a sealing petition before? *

No, never Yes, one Yes, two or more

For Your Client's Court Petition

We ask for this now so we don't have to track your client down later. This goes on the court petition and the request for the official criminal history record.

Client's Sex *

Client's Race *

As it appears on the criminal record, if known.

Name your client used at the time of arrest, if different from the name above

Date of arrest, if different from the offense date above

Arresting agency

Case number, if you know it

Client's Social Security Number

Optional. Used only for the official court petition and request for the criminal history record, and stored securely.

Submitted