Your Name

Your Email

Your Phone Number

Subject: Preliminary Application

Do you have a criminal record in CT?
YesNo
Are you currently on supervision?
YesNo
Do you have any pending charges in Connecticut or any other State or Federal jurisdiction?
YesNo
Have you received a Nolle at any time during the previous 13 months?
YesNo
Has it been three (3) years since the conviction date for your most recent Misdemeanor? (if applicable)
YesNon/a
Has it been five (5) years since the conviction date for your most recent Felony? (if applicable)
YesNon/a
Do you have any outstanding court fees, fines, Judicial motions, etc.?
YesNo

Pardon Application Checklist

Use this checklist for reference. If you have completed any of these steps, please indicate by checking them off so that we know where you might be in the process

Notarized Background AuthorizationState Police Bureau of Identification Background Check (Criminal History) ReportPolice Report(s) for any arrest(s) that resulted in a conviction that has occurred within the last 10 years; or letter(s) from the arresting police department stating the report(s) no longer exist(s)Probation letter indicating docket number(s,) completion date(s) and probation completion status (successful/unsuccessful) for each period of probation servedDD214 or DD Form 2 if applicable(3) Completed Reference Questionnaires (only one from a family member)Photocopy of your current/non-expired Driver’s License or State Identification CardProof of either employment or your source(s) of income (e.g., unemployment, disability payments, most recent W-2 form, letter/s from source of financial support, etc.)Any additional documentation you wish to include (e.g., certificates, resume, evaluations, )

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