Petition for Certificate of Relief from Disabilities or to Enlarge the Relief Previously Granted in a Certificate of Relief from Disabilities Print Form Clear Form (Rev. 12/06/06) CCCR 0510 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS PEOPLE OF THE STATE OF ILLINOIS or ______________________________________________, A Municipal Corporation, v. ______________________________________________, Defendant/Petitioner. } Case Nos. _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ ______________________________ PETITION FOR A CERTIFICATE OF RELIEF FROM DISABILITIES OR TO ENLARGE THE RELIEF PREVIOUSLY GRANTED IN A CERTIFICATE OF RELIEF FROM DISABILITIES Pursuant to 730 ILCS 5/5-5.5-5 et. seq. the Petitioner petitions the Court to order that Defendant/Petitioner has qualified for a Certificate of Relief From Disabilities or the relief previously granted in a Certificate of Relief From Disabilities shall be enlarged, and in support of the Petition states as follows: 1. Petitioner has not been convicted more than twice of a felony, as defined by 730 ILCS 5/5-5.5-5. 2. Petitioner was not convicted of a crime of violence under the Crime Victim’s Compensation Act, 740 ILCS 45/2 (which includes driving under the influence of intoxicating liquor or narcotic drugs). 3. Petitioner was not convicted of a Class X or a nonprobationable offense. 4. Petitioner was not convicted under Articles 11 or 12 of the Criminal Code of 1961, 720 ILCS 5/11-1 et. seq. 720 ILCS 5/12-1 et. seq. 5. Petitioner understands that, for purposes of this Petition, “conviction” includes a plea or a verdict of guilty upon which a sentence of probation, conditional discharge, or supervision has been imposed. 730 ILCS 5/5-5.5-5(iii). 6. Petitioner was not committed to an institution under the Department of Corrections. If Petitioner’s sentence was executed by commitment to an institution under the Department of Corrections, the petitioner should instead file his/her petition before the Illinois Prisoner Review Board on the application form provided by that agency.) 7. The Petitioner has previously been granted a Certificate of Relief from Disabilities on ___________________________________, _________ and seeks enlargement of that Certificate. (Attach a copy of the court order granting the Certificate.) 8. Petitioner seeks a license or certification pursuant to the following (check all that apply): The Animal Welfare Act Petitioner was not convicted under Section 3, 3.01, 3.02, 3.03, 3.03-1, or 4.01 of the Humane Care for Animals Act, 510 ILCS 70/3, 510 ILCS 70/3.01, 510 ILCS 70/3.02, 510 ILCS 70/3.03, 510 ILCS 70/3.03-1, or 510 ILCS 70/4.01, or Section 26-5 of the Criminal Code of 1961, 720 ILCS 5/26-5 The Illinois Athletic Trainers Practice Act, 225 ILCS 5/1 et seq. The Barber, Cosmetology, Esthetics, and Nail Technology Act of 1985, 225 ILCS 410/1-1 et. seq. The Boiler and Pressure Vessel Repairer Regulation Act, 225 ILCS 203/1 et. seq. The Professional Boxing Act, 225 ILCS 105/1 et. seq. The Illinois Certified Shorthand Reporters Act of 1984, 225 ILCS 415/1 et. seq. The Illinois Farm Labor Contractor Certification Act, 225 ILCS 505/1 et seq. The Interior Design Title Act, 225 ILCS 310/1 et. seq. The Illinois Professional Land Surveyor Act of 1989, 225 ILCS 330/1 et. seq. The Illinois Landscape Architecture Act of 1989, 225 ILCS 315/1 et. seq. The Marriage and Family Therapy Licensing Act, 225 ILCS 55/1 et. seq. The Private Employment Agency Act, 225 ILCS 515/0.01 et. seq. The Professional Counselor and Clinical Professional Counselor Licensing Act, 225 ILCS 107/1 et. seq. The Real Estate License Act of 2000, 225 ILCS 454/1-1 et. seq (OVER) (Rev. 12/06/06) CCCR 0510 B The Illinois Roofing Industry Licensing Act, 225 ILCS 335/1 et. seq. Professional Engineering Practice Act, 225 ILCS 325/1 et. seq. Water Well and Pump Installation Contractors License Act, 225 ILCS 345/1 et. seq. Electrologist Licensing Act, 225 ILCS 345/1 et. seq. The Auction License Act, 225 ILCS 407/5-1 et. seq. Illinois Architecture Practice Act of 1989, 225 ILCS 305-1 et. seq. The Dietetic and Nutrition Services Practice Act, 225 ILCS 30/1 et. seq. The Environmental Health Practitioner Licensing Act, 225 ILCS 37/1 et. seq. The Funeral Directors and Embalmers Licensing Code, 225 ILCS 41/1 et. seq. The Land Sales Registration Act of 1999, 765 ILCS 86/1-1 et. seq. The Professional Geologist Licensing Act, 225 ILCS 745/1 et. seq. The Illinois Public Accounting Act, 225 ILCS 450/0.01 et. seq. The Structural Engineering Practice Act of 1989, 225 ILCS 340/1 et. seq. 9. The Petitioner states the relief should be granted for the following reasons: _________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ (Attach additional pages and/or supporting documents when necessary.) 10. The relief to be granted by the Certificate is consistent with the public interest. 11. Petitioner understands that, for the purpose of determining whether the certificate shall be issued, the court may elect to request that the probation or court services department conduct an investigation of the Petitioner, and that they submit to the court a written confidential report in accordance with the request. 730 ILCS 5/5-5.5-15(c). WHEREFORE, the Petitioner petitions this court to: A. order that the Petitioner has qualified for a Certificate of Relief from Disabilities, or B. order that the Petitioner has qualified for enlargement of the relief offered by the Certificate of Relief from Disabilities previously issued to Petitioner. _______________________________________________ Signature of Pro Se Petitioner (or Attorney) 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, and as to such matters the undersigned certifies as aforesaid that s/he verily believes the same to be true. ________________________________________ ___________________________________________ Date Atty. No.: ________________ Signature of Petitioner Pro Se 99500 Attorney (or Pro Se Petitioner) Name: ___________________________________________ Address: _________________________________________ City/State/Zip: ____________________________________ Telephone: _______________________________________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS