I I I
I I I
Enter the Case Number given by the Circuit Clerk: _________________________________
I ask the Court to SEAL the following arrests, charges, or convictions from the records of the
Arresting Agency, the Circuit Clerk, and the Illinois State Police:
In 13, enter all eligible
arrests, charges, and
convictions you want
sealed. Enter all
charges for each case
number. For Outcome,
enter an outcome that
reflects the outcome of
your case. Use the
shortened version of
the outcome from the
Outcome
If you need more room
to list additional
eligible arrests or
charges use the
Additional Arrests or
Cases for Sealing form
and check the box.
14– 16 must be true for
For 14, traffic offenses
cannot be sealed unless
they were an eligible
Class A or B
misdemeanor.
In 17 - 21, check ALL
boxes that apply.
misdemeanor
supervisions and
convictions cannot be
sealed, like DUI, some
Reckless Driving
Offenses, Domestic
Battery, some Sexual
Offenses, and Dog
Fighting.
In 18b, some Class 3
and Class 4 felony
offenses can be sealed,
like Theft, Possession
of Cannabis,
Possession of a
Controlled Substance,
and a few others.
For a complete list of
crimes that can and
cannot be sealed, see
the How to Expunge
and/or Seal a Criminal
Record.
In 21, check the box if
you have completed one
of the listed educational
goals during your last
sentence. If 21 applies to
you, all eligible cases
can be sealed
immediately after the
completion of your last
sentence.
Number
Agency
(list all charges for each case
Arrest
example, MC,
Certificate of Eligibility for Sealing from PRB
Qualified Probation Successfully Completed
I have listed additional arrests or cases on the attached Additional Arrests or Cases for
I am not asking to seal arrests or charges for minor traffic offenses, unless I was released
I am not asking to seal arrests or charges for felony offenses, unless the felony was reduced
to an eligible misdemeanor, or is otherwise eligible to be sealed.
I am not asking to seal a felony conviction that happened after the sealing of a prior felony
At least 2 years have passed since I successfully completed my supervision, for eligible
At least 3 years have passed since the end of my last sentence (Unless #21 or 22 applies);
AND (Check all that apply):
I received a misdemeanor conviction for an offense subject to sealing;
I received a felony conviction for an offense subject to sealing. If it was a drug case,
I have attached the results of a drug test that I passed within the last 30 days.
I successfully completed a sentence under Section 10 of the Cannabis Control Act,
Section 410 of the Illinois Controlled Substances Act, Section 70 of the
Methamphetamine Control and Community Protection Act, or Section 5-6-3.3
(Second Chance Probation) of the Unified Code of Corrections; AND I have
attached the results of a drug test that I passed within the last 30 days.
I am not asking to seal a felony conviction for which I currently have to register on a
public registry, including the Arsonist Registration Act, the Sex Offender Registration Act,
or the Murder and Violent Offender Against Youth Registration Act.
For at least one case, I received a Certificate of Eligibility for Sealing by the Prisoner
Review Board. (Attach a copy of the Certificate.)
I am eligible to seal all eligible cases upon completion of my LAST sentence because
I received a high school diploma, associate's degree, career certificate, vocational or
technical certification, or bachelor's degree, or passed the high school GED Test; AND
I did so during the period of my LAST sentence, aftercare release, or mandatory