DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 2 þ Case No. þ Daley Ctr þ District 4 District 2 þ District 5 District 3 þ þ Domestic Violence CourtPetition for Transfer of Wireless Service þ (12/21/17) CCG N816 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOISXXX þ PETITION FOR TRANSFER OF WIRELESS SERVICENow comes the Petitioner þ , pursuant to the Illinois Domestic Violence Act (725 ILCS 5/112A-14), and movI certify to the Court that I am requesting the transfer of the wireless telephone number(s) contained in thispetition for my use and/or for the use of a minor child or children in my custody.2. Name of the Account Holder (Rþ 3. Billing Telephone Number of the Account Holder þ 4. Wireless Service Provider of the Account Holder that Serves the Account Listed Above:5. I am requesting that the court transfer the following telephone number(s) because the account currently belongsto the Respondent named in this petition. þ þ Me þ Child in my Care þ þ þ Me þ Child in my Care þ þ þ Me þ Child in my Care þ þ þ Me þ Child in my Care þ þ þ Me þ Child in my Care þ Telephone Number that Will Be TransferredPerson Who is Using the NumberName of Wireless Service Provider Associated With This Telephone IN RE: Petitionerand RespondentNo. þ Calendar: þ Criminal Case Number: þ Branch Number: þ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 2 of 2 þ Case No. þ Petition for Transfer of Wireless Service þ (12/21/17) CCG N816 B 6. I request that the court order the wireless telephone service provider(s) contained herein to transfer to theassociated with any mobile device associated with the telephone number(s) that will be transferred.7. I request that the court order the wireless telephone provider(s) to terminate the respondent222s use of thetelephone number(s) contained herein, unless the provider(s) notify the petitioner within 72 hours of receiptthat the wireless telephone provider is exempt from transfer under Subsection B of the Illinois DomesticViolence Act, 725 ILCS 5/112A-14. Signature of Petitioner Atty. No.: þ þ Pro Se 99500Atty Name: þ þ Atty. for: þ þ Address: þ þ City: þ þ State: þ Zip: þ Telephone: þ Primary Email: þ þ Secondary Email: þ þ Tertiary Email: þ þ