IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT COUNTY, ILLINOIS --------- [] THE PEOPLE OF THE STATE OF ILLINOIS or [ ] A MUNICIPAL CORPORATION, ) ) ) ) ) ) ) w. DefendantlPetitioner. CASE NO. ) PETITION TO SEAL ARREST RECORD COMES NOW the DefendantlPetitioner, pursuant to 20 ILCS 2630/5(h)(3)(A-C), and petitions the Court to seal the Defendant's arrest records from the records of the Arresting Authority, the Circuit Clerk and the Department of State Police with regard to the following arrest: Charge: _ Date of Arrest: _ Arresting Authority: _ ID No: _ Date ofBirth: Sex: _ In support of this Petition, DefendantlPetitioner Race: ------------ states as follows: 1. The DefendantlPetitioner was arrested by the Arresting Authority on the date and for the municipal ordinance violation, misdemeanor offense or Class 4 violation of 720 ILCS 5/11-14 stated above. 2. o The DefendantlPetitioner was released without being convicted; OR o The DefendantlPetitioner was found not guilty; OR o The DefendantlPetitioner was found guilty, but the conviction was reversed; OR The DefendantlPetitioner was released without conviction following a sentence of supervision, and at least 3 years have elapsed since the completion of DefendantlPetitioner's term of supervision, or terms of supervision, if more than one term has been ordered, and DefendantlPetitioner has not been convicted of a felony or misdemeanor or placed on supervision during such time. American LegalNet, Inc. www.FormsWorkflow.com 3. The DefendantlPetitioner was NOT convicted of or placed on court supervision for any of the following offenses: • 625 ILCS 11-501, et. seq. Driving under the Influence of Alcohol, Other Drug or Drugs, Intoxicating Compound or Compounds or any combination thereof, or • a violation of Article 11 of the Criminal Code of 1961, not including prostitution, or • 720 ILCS 5/26-5 Dog Fighting, or • a misdemeanor violation that is a crime of violence as defined in Section 2 of the Crime Victims Compensation Act (740 ILCS 45/2), which includes: • • • • • • • • • • 4. 720 720 720 720 720 720 720 720 ILCS ILCS ILCS ILCS ILCS ILCS ILCS ILCS 5/12-1 Assault. or 5/12-2 Aggravated Assault, or 5/12-3 Battery, or 5/12-3.2 Domestic Battery, or 5/12-15 Criminal Sexual Abuse, or 5/12-5 Reckless Conduct, or 5/12-15 Criminal Sexual Abuse, or 5/12-30 Violation of an Order of Protection, or 510 ILCS 70/1 a misdemeanor violation of the Humane Care for Animals Act, or 730lLCS 150/1 any offense or attempted offense that would subject a person to registration under the Sex Offender Registration Act. (Check whichever applies): D D 5. DefendantlPetitioner has no other arrests or convictions in this or any other Illinois Jurisdiction; OR DefendantlPetitioner has other arrests or convictions, which are listed and attached to this Petition, pursuant to 20 ILCS 2630/5(h)(7)(A). The DefendantlPetitioner has paid all costs and fees for the filing of this Petition, or has been granted a fee waiver by the Court. WHEREFORE, the DefendantlPetitioner prays that the Defendant's record of arrest be sealed as allowed by law. x--------------- DATED: DefendantlPetitioner Prepared By: Name -------------Address Atty No. Attorneyfor _ _ 2 American LegalNet, Inc. www.FormsWorkflow.com City/State/Zip _ Telephone _ 3 American LegalNet, Inc. www.FormsWorkflow.com VERIFICATION BY CERTIFICATION Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief, as to such matters the undersigned certifies as aforesaid he/she verily believes the same to be true. Date DefendantlPetitioner Subscribed and sworn to before me this day of , 20 Notary/Clerk Received this day of , 20 State's Attorney or Prosecutor 4 American LegalNet, Inc. www.FormsWorkflow.com