Request for Preparation of Record on Appeal (Rev. 8/28/08) CCA 0025 APPEAL TO THE APPELLATE COURT OF ILLINOIS FROM THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS _________________ DEPARTMENT, ______________________ DIVISION/DISTRICT ___________________________________________________ Plaintiff/Appell ______ v. ___________________________________________________ Defendant/Appell ______ } Reviewing Court No. _______________________________ Circuit Court No. _________________________________ Honorable ______________________________________ Trial Judge Date Notice of Appeal Filed ____________________, _______ REQUEST FOR PREPARATION OF RECORD ON APPEAL Attorney (or Party if no attorney): Name: ______________________________________________ Cook County Attorney Code No. _______________ or Pro Se 99500 Address: _____________________________________________ City: ____________________ State: _________ Zip: __________ Telephone Number: _____________________________________ E-mail Address (optional) __________________________________ Attorney for: _______________________________________________________________________________________________ Name of Party NOTICE IS HEREBY GIVEN to the Clerk of the Circuit Court of Cook County that __________________________________________________________ requests the preparation of the Record on Appeal in the above case. Name DESIGNATION OF RECORD The Clerk of the Circuit Court of Cook County shall prepare the Record on Appeal in accordance with Illinois Supreme Court Rule 321. The record on Appeal shall include the common law record, which consists of trial documents filed and judgments and orders entered by the trial court and: ‰ All documentary exhibits entered at trial, except for those other exhibits that cannot ordinarily be included for review and are subject to motion. ‰ Reports of Proceedings prepared in accordance with Illinois Supreme Court Rule 323. ‰ Certificate in Lieu of Record on Appeal pursuant to Illinois Supreme Court Rule 325. ‰ Documents filed under seal on the following dates and unsealed: _________________________________________________. A copy of the trial court Order authorizing these documents to be unsealed for the purpose of inclusion in the Record on Appeal is attached hereto or will be provided by the Appellant to the Civil Appeals Division at least 30 days in advance of the date on which the Record on Appeal is scheduled to be transmitted to the Appellate Court. Upon return of the Record on Appeal to the Circuit Court, it is the responsibility of the parties to obtain an Order resealing these records, if the records are to be resealed. ‰ Documents filed under seal on the following dates, which are to remain sealed: ___________________________________________. Please note that, pursuant to Rule 17 of Appellate Court of Illinois, “No record, exhibit, or brief may be filed under seal in the Appellate Court, unless Appellate Court has first given leave for filing under seal, notwithstanding that the material was filed under seal in the Circuit Court.” FEES Payment may be made by Cash, Check or Money Order. Cash payments accepted for in-person payments only. Checks or money order should be made to Clerk of the Circuit Court of Cook County. Pursuant to 705 ILCS 105/27.2a(k) and 27.2(k), the Clerk of the Circuit Court of Cook County must charge fees for Records on Appeal in advance as follows: 100 pages or less, $110 100 - 200 pages, $185 Each page in excess of 200, $.30/page Reduced fee for Local Governments and School Districts, $50 All prescribed fees are due in advance of transmission of the Record on Appeal. It is understood and agreed that once a request for preparation of a Record on Appeal is made by submission of this form, the Appellant is responsible for the costs of preparing the Record on Appeal, regardless of whether the Appeal is successful, dismissed, the time is extended, or a party elects to not transmit the Record on Appeal to the Appellate Court. The Clerk of the Circuit Court of Cook County reserves the right to pursue a claim to recover the costs and expenses, including reasonable attorneys’ fees, related to preparation of the Record on Appeal. ____________________________________________________ _______________________________________________ (Type or print name) (Signature of Appellant or Appellant’s Attorney) DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS