Certificate of Disposition/Conviction Form
In Person:
- May be purchased at the transaction window at the courthouse between 8:30am and 4:30pm.
- You will be asked to complete a form requesting the certificate. To obtain a sealed record, you must provide photo ID.
- Be sure to include the exact date(s) of arrest and as much information regarding the case as possible.
- There is a $5.00 fee for each certificate issued.
By Mail:
- Download and complete the Certificate of Disposition / Conviction Request Form.
- Be sure to include the exact date(s) of arrest and as much information regarding the case as possible.
- If there is a possibility your case may be sealed, be sure to complete the bottom portion of the form which will allow the sealed information to be accessed. Enclose a copy of your photo ID.
- Your signature must be verified by a notary public for the release of sealed information.
- Mail the completed form to Clarence Justice Court, Five Town Place, Clarence, NY 14031.
- Enclose a money order for the total amount due for the certificate(s) issued payable to the Clarence Justice Court and a self-addressed, stamped envelope.
Changed