Fillable Notice Juv Exp Illinois Statewide Forms - Notice of Filing for Juvenile Expungement 122117

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Notice Juv Exp Illinois Statewide Forms - Notice of Filing for Juvenile Expungement 122117

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This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts.
EXJ-N 3204.1
Page 1 of 2
(01/18)
STATE OF ILLINOIS,
NOTICE OF FILING FOR
JUVENILE EXPUNGEMENT
For Court Use Only
CIRCUIT COURT
COUNTY
Instructions
Directly above, enter
the name of county
where you will file the
case.
Request of:
Your name (First, middle, last name)
Enter your name and
birth date.
Date of birth
Enter all case
numbers you listed in
this area of your
Request form.
Case numbers for all of your juvenile court records in this County:
In 1, enter the State’s
Attorney’s Office in the
County where you are
filing.
1.
To:
County State’s Attorney’s Office
County Name
Street Address
City
State
ZIP
In 2, enter the police or
sheriff's department
that arrested you.
If there are more than
2, use the Additional
Arresting Agencies
form and check the box
and file it with this
Notice.
2.
To:
Police or Sheriff’s Department that arrested you:
Name
Name
Street Address
Street Address
City
State
ZIP
City
State
ZIP
I have listed additional Arresting Agencies on the Additional Arresting Agencies
form which I will file with this Notice.
3.
To:
Illinois State Police
260 North Chicago Street
Joliet, Illinois 60432
4.
I have filed a Request to Expunge Juvenile Records with the Circuit Clerk of
County, Illinois.
County Name
5.
The Circuit Clerk will mail a copy of this Notice and the Request to all of the agencies
listed above in sections 1 - 3.
EXJ-N 3204.1
Page 2 of 2
(01/18)
If you are completing
this form on a
computer, sign your
name by typing it. If
you are completing it
by hand, sign and print
your name.
/s/
Your Signature
Date
Prepared by:
Street Address:
City, State, ZIP:
Enter your name,
address, and phone
number.
Phone Number:
CERTIFICATE OF MAILING
DO NOT fill out this
section. The Circuit
Clerk will sign and
mail it.
The undersigned certifies that the above Notice and attached documents were placed in the U.S.
Mail with first class postage prepaid to all parties listed above.
Signature of Circuit Clerk
Name of Deputy Clerk
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Notice Juv Exp Illinois Statewide Forms - Notice of Filing for Juvenile Expungement 122117

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Completed 7 June 2020

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