Fillable Judicial Request for Removal of Personal Information Pursuant (Administrative Office of the Illinois Courts)

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Judicial Request for Removal of Personal Information Pursuant (Administrative Office of the Illinois Courts)

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The Judicial Request for Removal of Personal Information Pursuant (Administrative Office of the Illinois Courts) form is 1 page long and contains:

  • 1 signature
  • 21 check-boxes
  • 37 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Administrative Office of the Illinois Courts

BROWSE ADMINISTRATIVE OFFICE OF THE ILLINOIS COURTS (IL) FORMS

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______________________________________________ ________________________________
Judicial Request for Removal of Personal Information
Pursuant to the Judicial Privacy Act (705 ILCS 90/1 et seq.)
Judge's Name ___________________________
Type of Judgeship
❑ Supreme Court Justice
❑ Appellate Court Judge
❑ Circuit Judge
❑ Associate Judge
I request the following information be removed from public posting or display:
❑ Home Address
❑ Secondary Residence
❑ Home Phone Number
❑ Mobile Phone Number
Fax Number __________________________________
Email Address ________________________________
District: ____________________
Circuit: ____________________
Circuit: ____________________
❑ Pager Number
❑ Marital Status
❑ Personal Email Address
❑ Social Security Number
❑ Federal Tax ID Number
❑ Checking Acct. Numbers
❑ Savings Acct. Numbers
❑ Credit Card Numbers
❑ Personal information of the following individuals should be removed to the extent it could reasonably be
expected to reveal the judge's personal information:
Relationship to the Judge (Child Under Age 18,
Name of the Individual Spouse, Parent, Blood Relative Living at Same Address)
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
Governmental Agencies and Other Entities to be Notified
❑ Secretary of State
❑ Office of the Comptroller
❑ State Board of Elections
❑ County Government: ___________________ County
Judge's Signature
❑ School District: ______________________
❑ Major Online Data Vendors
❑ Other: _____________________________
❑ Other: _____________________________
Date
Please Return Completed Form To:
Administrative Services Division
Administrative Office of the Illinois Courts
3101 Old Jacksonville Road
Springfield, Illinois 62704
Email the Form to JudicialPrivacy@IllinoisCourts.gov
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Judicial Request for Removal of Personal Information Pursuant (Administrative Office of the Illinois Courts)

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Completed 20 July 2020

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