Print Form Petition to Seal Arrest Record Clear Form (Rev. 7/18/08) CCCR 0322 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS PEOPLE OF THE STATE OF ILLINOIS or ____________________________________________, A Municipal Corporation, v. _______________________________________________ Defendant/Petitioner } PETITION TO SEAL ARREST RECORD The Defendant/Petitioner petitions the Court to seal his/her arrest record from the records of the Clerk of the Circuit Court, the Department of State Police and the arresting authority(ies) with regard to the following arrest(s): Charge(s): ____________________________________________________________________________________________________ _____________________________________________________________________________________________________________ Date(s) of Arrest(s): _____________________________________________________________________________________________ _____________________________________________________________________________________________________________ Arresting Authority(ies) __________________________________________________________________________________________ _____________________________________________________________________________________________________________ ______________________________________________________________________ I. D. No. ______________________________________ Date of Birth: __________________________ Sex: ____________ Race: __________________________________ Current Address: _________________________________________________________________________________ In support of this Petition, Defendant/Petitioner states as follows: 1. The Defendant/Petitioner was arrested by the arresting authority(ies) on the date(s) and for the municipal ordinance violation(s) or misdemeanor offense(s) stated above. 2. The Defendant/Petitioner was released without being convicted; OR The Defendant/Petitioner was found not guilty; OR The Defendant/Petitioner was found guilty but the conviction was reversed; OR The Defendant/Petitioner was released without conviction following a sentence of supervision and was NOT charged with 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 misdemeanor violation of Article 11 of the Criminal Code of 1961, which includes Adultery, Fornication, Public Indecency, Marrying a Bigamist and/or Obscenity, 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: 720 ILCS 5/12-1 Assault, or 720 ILCS 5/12-2 Aggravated Assault, or (OVER) (Rev. 7/18/08) CCCR 0322 B 720 ILCS 5/12-3 Battery, or 720 ILCS 5/12-3.2 Domestic Battery, or 720 ILCS 5/12-5 Reckless Conduct, or 720 ILCS 5/12-15 Criminal Sexual Abuse, or 720 ILCS 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 730 ILCS 150/1 any offense or attempted offense that would subject a person to registration under the Sex Offender Registration Act. 3. The Defendant/Petitioner has not subsequently been convicted of any misdemeanor or felony and has not been placed on supervision for a misdemeanor or felony within THREE (3) years after the acquittal or release or reversal of conviction, or completion of the terms and conditions of the supervision. 4. The Defendant/Petitioner has paid all costs and fees for the filing of this Petition. WHEREFORE, the Defendant/Petitioner prays that his/her record of conviction(s) and all related records as maintained by the Clerk of the Circuit Court, the Department of State Police, and the arresting authority(ies) be sealed as allowed by law. ____________________________________ Signature of Defendant/Petitioner 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 Received this _______ day of ___________________, _________. _______________________________________ Signature of Defendant/Petitioner _______________________________________ State’s Attorney or Prosecutor Atty. No.: ________________ 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