Fillable IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS (State of Illinois Cook County Clerk of the Circuit Court)

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IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS (State of Illinois Cook County Clerk of the Circuit Court)

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Petition to Seal Criminal Records
(
12/01/20) CCCR 0333 A
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
Page 1 of 2
PETITION TO SEAL CRIMINAL RECORDS - FEE REQUIRED
The above named Petitioner states under oath that:
1. The Petitioner was arrested and/or charged on the date(s) and for the offense(s) stated below:
PEOPLE OF THE STATE OF ILLINOIS
or
____________________________________________________________
A Municipal Corporation,
v.
____________________________________________________________
Defendant/Petitioner
Case Nos. __________________________
__________________________
__________________________
__________________________
__________________________
__________________________
Date of Birth: _______________
Gender: Male Female
Race: _____________________
Case Number(s) Arresting
Agency(ies)
Charge(s) Date(s) of
Arrest
SID/IR/DCN/CB Disposition
Additional cases listed on attached page
Petitioner’s Address: _____________________________________________________________________________
_____________________________________________________________________________________________
2. The Petitioner’s arrest(s) or charge(s) not initiated by arrest was not a felony offense, unless the felony charge was
amended to a misdemeanor or otherwise eligible to be sealed.
3. The Petitioner’s arrest(s) or charge(s) not initiated by arrest resulted in order(s) of supervision or convictions that
are subject to sealing and s/he earned a high school diploma, associate’s degree, career certifi cate, vocational tech-
nical certifi cation, bachelor’s degree, or passed the school level Test of General Educational Development during
the requisite time period.
4. The Petitioner’s arrest(s) or charge(s) not initiated by arrest resulted in order(s) of supervision for an offense that
is subject to sealing, successfully completed by the petitioner, and the requisite time period has elapsed.
5. The Petitioner’s arrest(s) or charge(s) not initiated by arrest resulted in misdemeanor conviction(s) for an offense
that is subject to sealing, and the requisite time period has elapsed.
Petition to Seal Criminal Records
(12/01/20) CCCR 0
333 B
IRIS Y. MARTINEZ CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
Page 2 of 2
6. The Petitioner’s arrest(s) or charge(s) not initiated by arrest resulted in order(s) of fi rst offender probation for an
offense that is subject to sealing, the requisite time period has elapsed, and the Petitioner has attached a drug test.
7. The Petitioner’s arrest(s) or charge(s) not initiated by arrest resulted in a felony conviction for an offense that is
subject to sealing, the requisite time period has elapsed, and (for drug cases and cases authorized to be sealed by
the Illinois Prisoner Review Board) the Petitioner has attached a drug test.
8. The Petitioner has not previously had any felony conviction sealed or the Petitioner has not been convicted of any
felony offense after the date of an order granting the sealing of a felony conviction.
9. The Petitioner does not have any pending charges against him/her.
10. The Petitioner has received a certifi cate of eligibility for sealing from the Prisoner Review Board.
The relief should be granted for the following reasons:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
W, the Petitioner asks the Court to seal his/her arrest records.
Prepared by: _________________________________________
Cook County Attorney Code: ____________________________
Address: _____________________________________________
City/State/Zip: ________________________________________
Telephone: ___________________________________________
Primary Email: _______________________________________
Secondary Email: ______________________________________
Tertiary Email: ________________________________________
Dated: _________________________________
________________________________________
Defendant/Petitioner
Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, 735 ILCS
5/1-109, the undersigned certi es that the statements set forth in this instrument are true and correct,
except as to matters therein stated to be on information and belief and as to such matters the undersigned
certi es as aforesaid that s/he verily believes the same to be true.
Received this day ________of _______________
_______________________________________
(State’s Attorney/Prosecutor/ISP/Arresting Agency/
Chief Local Government Legal O ce)
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IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS (State of Illinois Cook County Clerk of the Circuit Court)

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Completed 26 April 2021

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