Change of Address Notification (4/26/05) CCG 0017 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS PEOPLE OF THE STATE OF ILLINOIS or ______________________________________________, A Municipal Corporation, v. ______________________________________________, Defendant/Petitioner. } Case Nos. ______________________________ _______________________________ _______________________________ ______________________________ _______________________________ _______________________________ CHANGE OF ADDRESS NOTIFICATION Pursuant to 20 ILCS 2630/5(h), or 705 ILCS 405/5-915, the Petitioner hereby notifies the Clerk of the Circuit Court that his/her address has changed since the time the Petition to Seal Arrest Record, Petition to Seal Conviction Record, or Petition to Expunge (Juvenile Records) was filed with the Clerk of the Circuit Court. Petitioner’s address has changed as follows: Former Address: ___________________________________________ City/State/Zip: _______________________________________ Street Address: Telephone: __________________________________________ Current Address: ___________________________________________ City/State/Zip: _______________________________________ Street Address: Telephone: __________________________________________ Date: _____________________________________, _________ ______________________________________________ Signature of Petitioner Atty. No.: _________________ Attorney (or Pro Se Petitioner): Pro Se 99500 _____________________________________________ Address: ___________________________________________ City/State/Zip: _______________________________________ Telephone: __________________________________________ Name: DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS (4/26/05) CCG 0017 B DELIVER COPIES OF THIS FORM WITH ORIGINAL SIGNATURES TO THE COURT HOUSE(S) WHERE YOUR PETITION(S) ARE BEING HEARD: JUVENILE CASES Juvenile Justice Division 1100 South Hamilton, Room 13 Chicago, Illinois 60612 ATTN: Change of Address DISTRICT 4 - MAYWOOD 1500 Maybrook Avenue Maywood, Illinois 60153 ATTN: Change of Address DISTRICT 1 -- CRIMINAL DEPARTMENTCHICAGO Richard J. Daley Center 50 West Washington Street, Room 1006 Chicago, Illinois 60602 ATTN: Change of Address DISTRICT 1 -- CRIMINAL DIVISION CHICAGO 2650 South California Avenue, Room 526 Chicago, Illinois 60608 ATTN: Change of Address DISTRICT 2 - SKOKIE 5600 Old Orchard Road Skokie, Illinois 60077 ATTN: Change of Address Cities and Villages within District 2: Deerfield, DesPlaines, Evanston, Glencoe, Glenview, Golf, Kenilworth, Lincolnwood, Morton Grove, Niles, Northbrook, Northfield, Park Ridge, Prospect Heights, Skokie, Wilmette, Winnetka, Cook County Sheriff, Cook County Forest Preserve, Illinois State Police Districts 3 and 15. DISTRICT 3 - ROLLING MEADOWS 2121 Euclid Avenue Rolling Meadows, Illinois 60008 ATTN: Change of Address Cities and Villages within District 3: Arlington Heights, Barrington, Barrigton, Hills, Bartlett, Bensenville, Buffalo Grove, Elgin, Elk Grove Village, Hanover Park, Harwood Heights, Hoffman Estates, Mount Prospect, Rolling Meadows, Roselle, Rosement, Schaumburg, Schiller Park, South Barrington, Streamwood, Wheeling, Cook County Sheriff, Cook County Forest Preserve, Illinois State Police Districts 2, 3 and 15. Cities and Villages within District 4: Animal Control, Bellwood, Berkeley, Berwyn, Broadview, Brookfield, Burlington North/Santa Fe Railroad, Cicero, Cook County Sheriff, Elgin/Joliet, Elmhurst, Elmwood Park, Forest Park, Forest Preserve, Franklin Park, Hillside, Hines Hospital, Illinois Commerce Commission, LaGrange Park, Maywood, Maywood Park District, Melrose Park, Memorial Park, Metra Police Department, Northlake, North Riverside, Public Safety, Oak Park, River Forest, River Grove, Riverside, Secetary of State Police, Stone Park, Triton College, Union Pacific Railroad, Water Reclamation, Westchester. DISTRICT 5 - BRIDGEVIEW 10220 South 76th Avenue Bridgeview, Illinois 60455 ATTN: Change of Address Cities and Villages within District 5: Alsip, Bedford Park, Bridgeview, Burbank, Burr Ridge, Chicago Ridge, Countyside, Crestwood, Evergreen Park, Forest View, Hickory Hills, Hinsdale, Hodgkins, Hometown, Indian Head Park, Justice, LaGrange, Lemont, Lyons, Merrionette Park, McCook, Oak Lawn, Orland Hills, Orland Park, Palos Hills, Palos Park, Stickney, Summit, Tinley Park, Western Springs, West Haven, Willow Springs, Worth, Cook County Sheriff, Cook County Forest Preserve, and Illinois State Police District 3 and 15. DISTRICT 6 - MARKHAM 16501 South Kedzie Parkway Markham, Illinois 60426 ATTN: Change of Address Cities and Villages within District 6: Blue Island, Burnham, Calumet City, Calumet Park, Chicago Heights, County Club Hills, Crete, Dixmoor, Dolton, East Hazelcrest, Flossmoor, Ford Heights, Glenwood, Harvey, Hazelcrest, Homewood, Lansing, Lynwood, Markham, Matteson, Midlothian, Oak Forest, Olympia Fields, Park Forest, Phoenix, Posen, Richton Park, Riverdale, Robbins, Sauk Village, South Chicago Heights, South Holland, Steger, Thornton. DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Print This Form For your protection and privacy, please press the Clear This Form button after you have printed the form. Clear This Form