Application Form For Destruction Of Juvenile Records, Setting Aside Adjudications, And/or Restoration Of Civil Rights - Mohave County Page 3

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Case No.____________________________
INSTRUCTIONS
1. Read the conditions listed under the request you are making.
2. Do not use this form unless you meet the conditions listed for that request.
3. Fill out the Affidavit and application: Print your answers using BLACK INK.
4. Sign the form. By signing this form, you are stating that the information you have entered is true, under
penalty of law.
5. Make two (2) copies of all pages of the Affidavit and application.
6. File the original and both copies with the Clerk of the Superior Court at one of the following locations:
401 E. Spring Street, Kingman, AZ
2222 Trane Road, Bullhead City, AZ
2001 College Drive, Lake Havasu, AZ
3 of 3
8/10/2009

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