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Clean Slate Program
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Clean Slate Application
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Post-Conviction Assistance
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Clean Slate Application
How would you like Clean Slate to update you about your application? (An attorney may need to send you official documents in the mail or call you to help with your case.)
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*
(required)
Date of Birth (mm/dd/yyyy)
*
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Date of Birth (mm/dd/yyyy)
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Other Names Used on Your Record (optional)
Phone Number
*
(required)
Alternate Phone Number (Optional)
Email Address
Mailing Address (Safe place you can receive email)
Street
*
(required)
City, State, Zip Code
*
(required)
Drivers License or ID Number
Last 4 Digits of Your Social Security Number
*
(required)
Citizenship Status
*
(required)
US Citizen
Legal Permanent Resident
Conditional Resident
Visa
DACA
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I don't know
Are you married or in a legal domestic partnership?
*
(required)
Yes
No
Case Number (If you know it)
Are you currently being charged with a crime?
*
(required)
Yes
No
I don't know
If yes, are you being charged as an adult?
Yes
No
I don't know
Are you being charged as a juvenile?
Yes
No
I don't know
Are you currently serving a sentence?
*
(required)
Yes
No
I don't know
Are you on probation or parole (Including MSR or PRCS)? (MSR is mandatory supervised release and PRCS is post release community supervision)
*
(required)
Yes
No
I don't know
If you are on probation or parole, what county is it in?
When does it end?
When does it end?
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Do you have a juvenile record?
*
(required)
Yes
No
If yes, is it in Fresno County?
Yes
No
If no, where were your juvenile matters heard?
Our partners use information about your income to give low income applicants special help and get help from government programs.
Monthly Household Income (Include your spouse or legal partner’s income. Your best estimate is okay.)
Where does your income come from?
*
(required)
Are you on any government benefits?
*
(required)
Yes
No
How much money do you have saved? (Your best estimate is okay)
How much do you spend each month on things like rent, groceries, utilities, medical expenses or childcare expenses? (Your best estimate is okay)
Do you own a home or rental property?
*
(required)
Yes
No
How many people depend on your financial support?
Reason(s) of Applying to Clear Your Record (Select all reasons that apply)
To pass a background check
I have a job offer pending
To qualify for housing
Immigration status issues
Was asked to leave job because of my record
End probation early
Homeless or on social services
I have a new case pending
My reason is not listed, see "Other Reason for Applying" below
Other Reason for Applying:
How did you hear about this program or website? (Optional)
To better assist you with your application, please help us get to know you by answering the following questions:
Why do you want to clean up your record?
What was going on in your life when you were arrested/convicted of this crime?
What have you done to improve your life since then?
What should the court know about you?
What do you hope to do by cleaning up your record?
Do you understand that not everyone qualifies for help, that submitting this form does not guarantee that you will be assisted by us, and that it may take 6 months to receive an initial response?
*
(required)
“ Yes, I understand”
Do you understand that this program and/or process will not restore firearm rights?
*
(required)
“Yes, I understand”
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