STATE OF LOUISIANA __________ JUDICIAL DISTRICT FOR THE PARISH OF ____________________ NO.:_________________________ DIVISION: _______________ STATE OF LOUISIANA vs. ________________________________ CERTIFICATION OF HUMAN TRAFFICKING VICTIM STATUS In accordance with the provisions of Louisiana Code of Criminal Procedure Article 983, the Office of the District Attorney has reviewed and determined that one, ________________________________________________________________________, RACE/ GENDER: _______________________DOB: ___________________________, SSN:_________________________________, has established by a preponderance of the evidence proof of status as a victim of human trafficking in accordance with the provisions of R.S. 14:46.2, for the following offense(s), detailed specifically as follows: (If more than one offense, each relevant offense must be specifically listed in the following format) OFFENSE:________________________ DOCKET NO:_____________________ CHARGE:________________________ DATE OF ARREST:________________ ARRESTING AGENCY:____________ CITY/PARISH OF ARREST:___________________ FURTHER, that the above offense(s) for which this Certification issued was committed, in substantial part, as a result of the above-named being a victim of human trafficking, in accordance with R.S. 14:46.2. FURTHER, this Certification shall be considered as prima facie evidence of the victim's status in similar eligible crimes committed within other Louisiana jurisdictions during the time period in which the above-named was a victim of human trafficking. FURTHER, all applicable time delays pertaining to expungement contained in Louisiana Code of Criminal Procedure Articles 977 and 978 shall be waived when presented to the clerk of court with an application for expungement of the above-specified offense(s). FURTHER, any application for expungement of the above-specified offense(s) shall be at no cost to the above-named victim. _______________________ __________________________________ DATE DISTRICT ATTORNEY PARISH OF _____________ JUDICIAL DISTRICT STATE OF LOUISIANA
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