APPLICATION FORM FOR REMOVAL OF CRIMINAL RECORD

 

 

                                                       SOCIALIST REPUBLIC OF VIETNAM

                                                        Independence - Freedom - Happiness

                                                                   —————————

 

                                                                                                            ……….., day …. month....year ……..

 

                           APPLICATION FORM FOR REMOVAL OF CRIMINAL RECORD

To: People's Court ……………………………………………………. ................................. ............................

My name is: …………………………. Year of birth: ………… Gender: …………………….................. ..........

Permanent address: ……………………………………………….……….…….................... ............................

Temporary residence address: ……………………………………………………………………………………..

I am a defendant in a criminal case …………. was arrested by the People's Court of …………........Trial at

Judgment No…../…… day ……. May ……. about the crime of ………… with the penalty of ……………….

To date ………..… month …........… year …..………. I have finished serving the decisions of the judgment.

I request the People's Court of ……….………................…… to consider clearing my criminal record for me.

Attached to the application for criminal record remission are the following documents:

1……………………………………………………………………………………………..........................................

2……………………………………………………………………………………………...........................................

3……………………………………………………………………………………………...........................................

 

Comments of the commune, ward, township or agency or organization
wherethe applicant resides or works

            APPLICANT

 
  (signature, write full name)