Marijuana Pardon Webform_1

OMB Control No: 1123-0014
Application for Certificate of Pardon for Simple Possession of Marijuana

Certificate of Pardon for the Offense of Simple Possession of Marijuana on or before October 6, 2022

On October 6, 2022, President Biden issued a presidential proclamation that pardons federal convictions for simple marijuana possession offenses.

How a pardon can help you

A pardon is an expression of the President's forgiveness. It does not signify innocence or expunge the conviction. But it may remove civil disabilities -- such as restrictions on the right to vote, to hold office, or to sit on a jury -- that are imposed because of the pardoned conviction. It may also be helpful in obtaining licenses, bonding, or employment. Learn more about the pardon

How to qualify for the pardon

You qualify for the pardon if:

• On or before October 6, 2022, you were charged with or convicted of simple possession of marijuana by either a federal or D.C. Superior court

• You were a U.S. citizen or lawfully present in the United States at the time of the offense

• You were a U.S. citizen or lawful permanent resident on October 6, 2022

Request a certificate to show proof of the pardon

A Certificate of Pardon is proof that you were pardoned under the proclamation. The certificate is the only documentation you will receive of the pardon.

What you'll need for the request

About you

You must provide personal details like name, mailing address, email address, and citizenship status.

 

About the charge or conviction

You must state whether it was a charge or conviction, the court district where it happened, and the date (month, day, year). If possible, you should also:

• provide information about your case (docket or case number and the code section that was charged)

• provide copies of documentation, such as:

  • charging documents (indictment, complaint, or criminal information; or

  • conviction documents (judgment of conviction or the court docket sheet showing the sentence and date it was imposed)

Without this information, we can't guarantee that we'll be able to determine if you qualify for the pardon under the proclamation.

How to submit a request

The fastest way to submit a request is online through this website. If you send us the request form (PDF) by email or mail, it may take longer to process it.

 

You can submit a request for yourself or someone else can submit it on your behalf.

 

By email

Download the request form (PDF) and email the completed form to [email protected]. If you include charging or conviction documents with the request, attach PDF copies of them to the email.

 

By mail

Print the request form (PDF) and mail the completed form to:

 

U.S. Department of Justice
Office of the Pardon Attorney
950 Pennsylvania Avenue NW
Washington, DC 20530

If you are including charging or conviction documents with the request, send copies of them with the request form.

 

Online on this website

Applicant information

You can submit a request for yourself or someone else can submit it on your behalf.

First name  (required)

Middle name 

Last name  (required)

Suffix 

Check this box if you had a different name at the time of charge or conviction.

     

Contact information

How do you want to be contacted about your request? (required)

Email (strongly recommended because it's the fastest)

If you don't have an email address, enter one that belongs to someone who is helping you.

Physical mail

This may delay the processing of your request. If you don't have a place where you can get mail, enter a mailing address that belongs to someone who is helping you.

 

Email address where we should send updates

Enter email address (required)

Enter email address again to confirm (required)

 

Current mailing address

You can also enter a mailing address, but it's not required. We'll only send you mail if we can't reach you via email.

Check this box if the address you want to use is not in the United States

  

Street address 1

Street address 2 

City

State                                                                                                                   

ZIP Code

Name (if it's not your address or someone else will get the mail on your behalf) 

 

Phone number

You can also enter a phone number, but it's not required. We'll only call you if we're unable to reach you via other methods. If you don't have a phone number, enter one that belongs to someone who is helping you.

 

Date and place of birth

Date of birth (required)

Month 

Day 

Year 

                         

                                                               

                                                                                                                                                                                                                                               

 

Country where you were born  (required)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 

 

City where you were born  (required)

  

Gender and race

We'll use this information to analyze who has been affected by the proclamation.

 

Gender        

 

Are you Hispanic or Latino? 

Yes

No

 

Race (select all that apply) 

Alaska Native or American Indian

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Other

 

Citizenship status

Citizenship or residency status  (required)

U.S. citizen by birth

U.S. naturalized citizen

Lawful permanent resident

    

About the charge or conviction

If you have multiple charges or convictions, please submit a separate application for each one.

 

Were you charged or convicted?  (required)

Charged - I was charged (not convicted) with simple possession of marijuana in a U.S. District Court or D.C. Superior Court.

Convicted - I was convicted of simple possession of marijuana in a U.S. District Court or D.C. Superior Court.

  

Which U.S. District Court or D.C. Superior Court heard your case?                                                                                                                                                                                                

  

Enter the Code Section, the statute of your charge/conviction 

 

Enter the Docket Number assigned to your case by the court 

 

Supporting documents

Upload documentation related to your case, such as:

• The charging document, including the indictment, complaint, or criminal information; or

• The judgment of conviction, or the court docket sheet showing the sentence and date it was imposed

Save the document as a PDF before you upload it, if possible.

 

Upload document(3 MB Max)

 

Certifications

With knowledge of the penalties for false statements to Federal Agencies, as provided by 18 U.S.C. § 1001, and with knowledge that this statement is submitted by me to affect action by the U.S. Department of Justice, I certify that:

1. The applicant was either a U.S. citizen or lawfully present in the United States at the time of the offense; and

2. The applicant was a U.S. citizen or lawful permanent resident on October 6, 2022; and

3. The statements and accompanying documents included in this form are true and complete to the best of my knowledge, information, and belief; and

4. I acknowledge that any certificate issued in reliance on the above information will be voided, if the information is subsequently determined to be false; and

5. The applicant has read and understands the Privacy Act Statement:

The Office of the Pardon Attorney has authority to collect this information under the U.S. Constitution, Article II, Section 2 (the pardon clause); Orders of the Attorney General Nos. 1798-93, 58 Fed. Reg. 53658 and 53659 (1993), 2317-2000, 65 Fed. Reg. 48381 (2000), and 2323-2000, 65 Fed. Reg. 58223 and 58224 (2000), codified in 28 C.F.R. §§ 1.1 et seq. (the rules governing petitions for executive clemency); and Order of the Attorney General No. 1012-83, 48 Fed. Reg. 22290 (1983), as codified in 28 C.F.R. §§ 0.35 and 0.36 (the authority of the Office of the Pardon Attorney). The principal purpose for collecting this information is to enable the Office of the Pardon Attorney to issue an individual certificate of pardon to you. The routine uses which may be made of this information include provision of data to the President and his staff, other governmental entities, and the public. The full list of routine uses for this correspondence can be found in the System of Records Notice titled, "Privacy Act of 1974; System of Records," published in Federal Register, September 15, 2011, Vol. 76, No. 179, at pages 57078 through 57080; as amended by "Privacy Act of 1974; System of Records," published in the Federal Register, May 25, 2017, Vol. 82, No. 100, at page 24161, and at the U.S. Department of Justice, Office of Privacy and Civil Liberties' website.

You consent to allowing the Office of the Pardon Attorney to obtain information regarding your citizenship and/or immigration status from the courts, from other government agencies, from other components within the Department of Justice, and from the Department of Homeland Security, U.S. Citizenship and Immigration Services (DHS-USCIS), Systematic Alien Verification for Entitlements (SAVE) program. The information received from these sources will be used for the sole purposes of determining an applicant's qualification for a Certificate of Pardon under the October 6 proclamation and for record-keeping of those determinations. Further, please be aware that if the Office of the Pardon Attorney is unable to verify your citizenship or immigration status based on the information provided below, we may contact you to obtain additional verification information. Learn more about the DHS-USCIS's SAVE program and its ordinary uses.

Your disclosure of information to the Office of the Pardon Attorney on this form is voluntary. If you do not complete all or some of the information fields in this form, however, the Office of the Pardon Attorney may not be able to effectively respond. Information regarding gender, race, or ethnicity is not required and will not affect the processing of the application.

 

If you're filling this form out for yourself, enter your name below. If you're filling this out for someone else, enter your own name, not the applicant's.

 

First name (required)

 

Middle name

 

Last name (required)

 

Suffix

 

Disclaimer

This webform is authorized by the United States Department of Justice and controlled by a third-party vendor, Leidos Digital Solutions, Inc. Reference in this webform to any specific commercial product, process, service, manufacturer, or company is not an endorsement or recommendation by the United States Government or the United States Department of Justice. The information made available to, collected, stored, and used by the Department is done so consistent with the DOJ Privacy Policy. The third-party vendor collects certain user information when users access the site consistent with its obligations under its contract with the Department, which is consistent with Leidos Digital Solutions, Inc's privacy policy.