Petition To Expunge And Impound Criminal Records - Court Of Cook County, Illinois

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Petition to Expunge and Impound Criminal Records
(01/20/17) CCCR 0330 A
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
No. _______________________________________________
 PEOPLE OF THE STATE OF ILLINOIS
or
_______________________________________________
 _________________________________________________
_______________________________________________
A Municipal Corporation
v.
_______________________________________________
_______________________________________________
___________________________________________________
Defendant/Petitioner
Date of Birth: ___________________
Gender:  Male  Female
Race: _________________________
PETITION TO EXPUNGE AND IMPOUND CRIMINAL RECORDS - FEE REQUIRED
Th e above-named Petitioner states under oath that:
1.  Th e Petitioner was arrested and/or charged on the date(s) and for the off ense(s) stated below:
Case Number(s)
Arresting
Charge(s)
Date(s) of
SID/IR/DCN/CB
Disposition
Agency(ies)
Arrest
 Additional cases listed on attached page.
Petitioner’s Address: _______________________________________________________________________
_______________________________________________________________________________________
2.  Each arrest or charge not initiated by arrest, other than a minor traffi c off ense resulted in
a.  an order of supervision was successfully completed for an off ense that is subject to expungement and
the requisite time period has elapsed.
b.  an order of qualifi ed probation was successfully completed for an off ense that is subject to expunge-
ment and the requisite time period has elapsed and the Petitioner has attached proof to this Petition
that s/he has passed a drug test taken within 30 days before the fi ling of this Petition showing the
absence within his or her body of all illegal substances; and/or
c.  Th e Petitioner was granted a pardon by the Governor which specifi cally authorizes expungement.
3.  Th e Petitioner does not have pending charges against him/her.
DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
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