RestorationofCivilRights

NonviolentOffendersApplication
VIRGINIARESTORATIONOFCIVILRIGHTSAPPLICATIONFORM
Usethisformtoapplyforrestorationofcivilrights.

Toapplyforrestorationofcivilrights,youmust:

BearesidentofVirginia,and/orhavebeen
convictedofafelonyinaVirginiacourt,aU.S.
DistrictCourt,oramilitarycourt
Havepaidallcosts,fines,and/orrestitution
associatedwithyourconvictions.
Completeatwo(2)yearwaitingperiodafter
completionofsentenceand/orreleasefrom
supervisedprobationorparole

Nothaveanymisdemeanorconvictions
and/orpendingcriminalchargestwo(2)
yearsimmediatelyprecedingthe
application
NothaveaconvictionforDWIwithinthe
pastfive(5)yearsimmediatelypreceding
theapplication

Personswhohavebeenconvictedofaviolentoffense,adrugmanufacturingordistributionoffense,crimes
involvingchildren,oranelectionlawoffensearenoteligibleforthisprocessusingthisform.
Call(804)7862441orgoonlinetowww.commonwealth.virginia.govtogettheappropriateform.
TheSecretaryoftheCommonwealthwillconductacriminalhistoryandDMVcheckonallapplicants.
Thecivilrightsrestoredthroughthisprocessincludetherightsto:

Registertovote
Holdpublicoffice
Serveonajury
Serveasanotarypublic

Therestorationofrightsdoesnotrestoretherighttopossessafirearm.Youmustpetitiontheappropriate
circuitcourtpursuanttoVa.Code18.2308.2.Italsodoesnotexpungeacriminalcharge,whichcanonlybe
donebypetitioningacircuitcourtpursuanttoVa.Code19.2392.1and19.2392.2.
Thisisnotapardon.Apersonwhohasbeenconvictedofafelonymustfirsthavehisorherrightsrestoredin
ordertobeconsideredforasimplepardon.
ApplicantsresidingoutsidetheCommonwealthofVirginiamustincludeacertifiedcopyoftheirDrivingand
CriminalRecordfromthestatetheyreside.
Inanefforttosignificantlyexpeditethedecisionmakingprocess,ifyouhaveacertifiedcopyofthefelony
sentencingorderandproofofpaymentofcourtorderedcosts,finesand/orrestitution,youmayincludethat
withtheapplication. Ifnotincluded,theOfficeoftheSecretaryoftheCommonwealthwillrequestsuchcopies
fromtheappropriatecourt. TheSecretaryoftheCommonwealthwillalsorequesttherequiredinformation
fromthepetitionersprobationofficer,ifapplicable.Theapplicationwillnotbeconsideredtobecompleteuntil
theSecretaryoftheCommonwealthreceivessuchinformation.
IfthereisanyadditionalinformationyouwouldliketoprovidetheGovernorforconsiderationofyourrequest,
pleasefeelfreetodoso.
TheGovernorhasthesolediscretiontorestoreapersonscivilrightsundertheVirginiaConstitution.Thereis
noprocessforappealinghisdecision.Apersonwhohasbeendeniedmayreapplyafteroneyear.Thegoalof
theAdministrationistohavealldecisionsmadewithin60daysofthereceiptofacompleteandeligible
application,withwrittennoticegiventotheapplicant.
Ifyouhaveanyquestions,pleasecall(804)7862441orwritetotheaddressshownbelow.
Mailto:RestorationofRights,SecretaryoftheCommonwealth,P.O.Box2454,Richmond,VA23218

ApplicationforRestorationofRightsforCertainNonviolentOffenders
LegalNameNowUsed(PleasePrint):______________________________________________Male_____Female_____
NameasConvicted(PleasePrint):___________________________________________________________________
DateofBirth:________________________________SocialSecurityNumber:________________________________
StreetAddress:___________________________________________________________________________________
City,StateandZip__________________________________________________________________________________________
MailingAddress(ifdifferentfromabove):_______________________________________________________________
HomePhone:__________________ WorkPhone:___________________ CellPhone:____________________
Email(ifavailable):_____________________________________________
Pleaseindicateabovebycheckingtheappropriatebox(checkallthatapply)thenumberwhereyoumaybereached
shouldweneedadditionalinformation.
FelonyOffense(s)forWhichyouseekRestorationofRights:_______________________________________________
______________________________________________________________________________________________
PleaseprovideabriefdescriptionofcommunityorcomparableserviceoranyotherinformationyouwouldliketheGovernorto
know(Optional):
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

CourtinWhichConvicted:__________________________ County/State:__________________________________

Date(s)ofSentence
(MM/DD/YYYY):

DateofReleasefrom
SupervisedProbation,
__________________________ ifany(MM/DD/YYYY): _________________________

Instructions:Thisaffidavitmustbesignedinthepresenceofanotarypublicorotherofficialempoweredtoadminister
_______________________________________________________________________________________________
anoath.
AFFIDAVIT
I,theundersigned,dosolemnlyswear(oraffirm)thattheinformationonthisapplication,includingallattachments,is
complete,accurate,andtrue.
________________________________________________
SignatureofApplicant
CommonwealthofVirginia
__________________________________________________
City/Countyof____________________
communityorcomparableservice:___________________________________________________________________
Subscribedandswornbeforemethis_____dayof______________________________year______________.
___________________________________________
NotaryPublic
MyCommissionExpires:___________________________