(Rev. 9/14/04) CCG 0033 IN THE CIRCUIT COURT COOK COUNTY, ILLINOIS People of the State of Illinois ____________________________________________ Plaintiff v. No. ________________________________________ ____________________________________________ Defendant RESTITUTION ORDER The Defendant, ______________________________________________________________________, having been convicted of the offense of _______________________________________________________________________________ ________________________________________________________________________________________________________, and the Court having, as a part of the disposition of this case, sentenced the Defendant to make restitution to _______________________________________________________________________________________________________ hereafter designated the Victim, and having conducted a pre-sentencing hearing to assess the financial capacity of the Defendant to make restitution. It is ordered that restitution in the amount of ________________________________________________________ shall be made by the Defendant to said Victim payable as follows: _______________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ It is further ordered that all money deposited for bail in excess of actual court costs shall be paid to said Victim to apply on account of said restitution, not less than 30 days after the date of this Order. Dated: ___________________________, _________ ________________________________________ Judge Judge's No. INSTRUCTIONS CLERK is requested to fill in the following information: Bond No. __________________________________ Name of Victim ____________________________________________________________ Address of Victim ___________________________________________________________________ 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