Petition for Expedited Judicial Determination of Factual Innocence (Financial Identity Theft) PEOPLE OF THE STATE OF ILLINOIS or _________________________________________________ A Municipal Corporation v. ___________________________________________________ Defendant, ___________________________________________________ Petitioner, (1/20/16) CCCR 0020 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Case No. ___________________________________________ PETITION FOR EXPEDITED JUDICIAL DETERMINATION OF FACTUAL INNOCENCE (FINANCIAL IDENTITY THEFT) Pursuant to 720 ILCS 5/16G-30, the Petitioner petitions the Court to make expedited judicial determination of factual innocence in the cases listed below, on the grounds that the Petitioner was the victim of financial identity theft: 1. Case Number Falsely Containing Petitioner's Identity: ____________________________________________________ Charge(s) Against Defendant in Above Case: ____________________________________________________________ Date of Arrest: _____________________________ Arresting Agency/Agencies: _______________________________ Defendant's IR/SID # if any: __________________ Petitioner's IR/SID #, if any: _______________________________ Petitioner's Date of Birth: ______________________ Sex: ________ Race: __________________________________ I am a victim of financial identity theft by the same Defendant in more than one case. I have provided the above-requested information for each additional case on the attached form. 2. In support of this Petition, Petitioner states as follows: Check appropriate box(es): The perpetrator of the financial identity theft was arrested for, cited for, or convicted of crime(s) under the Petitioner's identity; or a criminal complaint was filed against the perpetrator in the Petitioner's name, or the Petitioner's identity has been mistakenly associated with a criminal conviction. 3. The Petitioner is factually innocent of the charge(s) for which the arrest(s), citation(s), conviction(s) or criminal complaint(s) were made, or in which his/her identity has been mistakenly associated. (Please attach copies of any supporting documents to this Petition, e.g. affidavits, police reports, or other material relevant, and reliable information.) WHEREFORE, the Petitioner petitions this Court to A. Determine that there is no reasonable cause to believe that the Petitioner committed the offense, and to issue an Order certifying that the Petitioner is factually innocent of the charges in the cases listed on this form. B. Order the Petitioner's name and associated personal identifying information contained in the above-listed court records, files, and indexes accessible by the public be sealed, deleted, or labeled to show that the data is impersonated and does not reflect the Petitioner's identity. C. Order that the Petitioner's name and associated personal identifying information contained in the above-listed court re cords, files, and indexes accessible by the public be sealed, deleted, or labeled to show that the data is impersonated and does not reflect the Petitioner's identity. VERIFICATION BY CERTIFICATION Date: ______________________________________________ Atty. No.: ___________________ Pro Se 99500 Under penalties as provided by law pursuant to Attorney (or Pro Se Petitioner): Section 1-109 of the Code of Civil Procedure, the unName: _____________________________________________ dersigned certifies that the statements set forth in this Address: ____________________________________________ instrument are true and correct, except as to matters City/State/Zip: _______________________________________ therein stated to be on information and belief, and as to such matters the undersigned certifies as aforesaid Telephone : _________________________________________ that s/he verily believes the same to be true. Primary Email: ______________________________________ __________________________________________ Secondary Email: _____________________________________ Tertiary Email: _______________________________________ Page 1 of 1 Signature of Petitioner DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS American LegalNet, Inc. www.FormsWorkFlow.com