Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinois þ cookcountyclerkofcourt.orgPage 1 of 1Petition/CBR to Attorney þ (05/25/18) CCG N022 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOISDEFENDANT222S PETITION PURSUANT TO 725 ILCS 5/110-7REQUESTING REFUND OF BAIL TO ATTORNEY OF RECORD VERIFICATION BY CERTIFICATIONORDER PEOPLE OF THE STATE OF ILLINOISorVillage, City, Town: þ þ v. þ Defendant/PetitionerCase No. þ Bond No. þ Amount of Bond $ þ Amount of Deposit $ þ Branch/Room þ Petitioner, , the Defendant in the above-captioned case respectfully says:1. þ That s/he has performed all the conditions of his/her bond.2. þ That s/he has agreed that the Clerk of the Court pay the refund due to his/her attorney of record in payment for legal services ren-dered.3. þ That s/he waives all claims, title and interest in the said bail deposit.4. þ That if the bond was posted by a provider other than the Defendant, the provider has signed the bond slip acknowledging that any refund due can be used to pay for Defendant222s attorney222s fees, and all other fees and costs as ordered by Court.Wherefore Petitioner requests that any refund be paid to: þ , the attorney of record.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 Dated: þ þ Defendant Signature: þ This cause coming on to be heard on the petition of the Defendant, the Defendant being present in open court, and the Court after con-sidering the petition, interest of any parties in said bail deposit, and being fully advised in the premises;IT IS ORDERED not withstanding any assignment of bail bond money, that Dorothy Brown, Clerk of the Circuit Court of Cook County, pay to attorney of record: þ þ Print Attorney Name þ Attorney Numberany refund due the Defendant on the above bail bond, pursuant to 725 ILCS 5/110-7. Entered:Date: þ þ þ Judge þ Judge222s No.INSTRUCTIONSAttorney is requested to:1. þ 2. þ attach a copy of bond signed by the Defendant and provider (if different from Defendant) to the petition. Atty. No.: þ Name: þ þ Atty for: þ Address: þ þ City: þ þ State: þ þ Zip: þ Telephone: þ Primary Email: þ þ American LegalNet, Inc. www.FormsWorkFlow.com