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Second Chance Client Intake Form

GROW. THRIVE.

Thank you for your interest in Second Chance, a program of The Second Paycheck.

This intake helps us understand where you currently are in the record sealing or expungement process and prepare for your Second Chance information and onboarding call.

The Second Paycheck is not a law firm and does not provide legal advice or legal representation. We do not determine whether you are legally eligible to seal or expunge a record. Eligibility and outcomes are determined by appropriate government agencies and courts.

Please do not enter your social security number, drivers license number, banking information or other sensitive information on this form.

Please answer the questions based on what you know or what appears on your court documents. If you do not know an answer, select "I'm not sure."

Submitting this form does not guarantee eligibility, acceptance into the pilot, or any particular outcome.