How do I submit the Arrest Record Restriction Request?

For arrests before July 1, 2013, apply at the arresting agency. The agency completes its section and forwards the form to the prosecutor. If approved, follow the instructions for sending it to GCIC.

Who completes each section of the form?

The applicant completes Section One, the arresting agency completes Section Two, and the prosecuting attorney completes Section Three.

Does this form apply to arrests on or after July 1, 2013?

The instructions say there is no application process for arrests occurring on or after July 1, 2013; the prosecutor may approve restriction at sentencing.

Laurens County, GA · Laurens County

No notary required

Request to Restrict (Expunge) Arrest Record

This request form is for applicants seeking to restrict an arrest record for an arrest that occurred before July 1, 2013.

At a glance

Issued by: City of Laurens County · Laurens County, Laurens County, Georgia
Notarization: Not required: file this form without a notary.
Official source: laurenscoga.org
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Applicants complete Section One with personal and arrest details and sign and date the request. The arresting agency completes Section Two, then forwards the form to the prosecutor for a decision in Section Three. The instructions say applicants must apply at the arresting agency for arrests before July 1, 2013; arrests on or after that date have no application process described here.

Who needs it

A person seeking restriction of an arrest record for an arrest before July 1, 2013, applies through the agency that made the arrest.

How to submit it

Complete Section One and apply at the arresting agency, which completes Section Two and forwards the form to the prosecutor. If approved, follow the instructions for sending it to GCIC, including the $25 fee when required.

About notarization

This form has no notary block; the applicant signs and dates it, and the instructions mention no notarized or sworn attachment.

How to submit this form

1
Download the Request
Download the Request to Restrict Arrest Record form and instructions.
2
Complete Section One
Fill in the applicant and arrest information, then sign and date the request.
3
Apply at the Arresting Agency
For an arrest before July 1, 2013, apply at the arresting agency; it completes Section Two and forwards the form to the prosecutor.
4
Follow the Approval Instructions
If approved, follow the form instructions for forwarding the application to GCIC and including its required fee.

Frequently asked questions

Do I need a notary for the Arrest Record Restriction Request?: No. This form has no notary block; the applicant signs and dates it, and the instructions mention no notarized or sworn attachment.
How do I submit the Arrest Record Restriction Request?: For arrests before July 1, 2013, apply at the arresting agency. The agency completes its section and forwards the form to the prosecutor. If approved, follow the instructions for sending it to GCIC.
Who completes each section of the form?: The applicant completes Section One, the arresting agency completes Section Two, and the prosecuting attorney completes Section Three.
Does this form apply to arrests on or after July 1, 2013?: The instructions say there is no application process for arrests occurring on or after July 1, 2013; the prosecutor may approve restriction at sentencing.

Need something notarized?

This Request to Restrict (Expunge) Arrest Record doesn’t need a notary, but if you have another Laurens County form that does, a commissioned online notary can help.