Print Form Clear Form (Rev. 4/21/09) 351*006 Cook County Attorney Code Request Form COOK COUNTY ATTORNEY CODE REQUEST FORM Please complete the information requested below. Indicate whether this request is for a firm or individual attorney code. Also indicate whether the request is for a new attorney code or change of contact information. If you are requesting a firm attorney code, an attorney in that firm must provide his/her documentation as described below. NOTE: NAME INFORMATION CANNOT BE CHANGED! Documentation needed: All requests must be accompanied by copies of your current and valid Illinois Attorney Registration & Disciplinary Commission (ARDC) card AND your valid government-issued driver’s license or identification card. If you are an out-of-state attorney not licensed to practice law in Illinois, please contact (312) 603-5469 for further information. (NOTE, YOUR APPLICATION WILL NOT BE PROCESSED WITHOUT YOUR ARDC INFORMATION.) Requests, except for those in person, will be processed from 9:00 a.m. to 3:00 p.m., Monday through Friday, excluding court holidays. REQUESTS RECEIVED AFTER 3:00 p.m. WILL BE PROCESSED ON THE FOLLOWING BUSINESS DAY. You may submit this request any of the following ways: 1. 2. 3. 4. Via facsimile: Fax your completed request and copies of the above supporting documents to (312) 603-3348. Via email: Email your completed request and copies of the above supporting documents to attorneycode@cookcountycourt.com. In person: Bring your completed request along with the original supporting documents to the Law Division in Room 801 of the Richard J. Daley Center, 50 West Washington Street, Chicago, Illinois 60602 or the Civil Department at any of the Suburban Districts (processed 8:30 a.m. to 4:30 p.m., entire business day). Via U.S. Mail: Mail your completed request and copies of the above supporting documents to the Law Division in Room 801 of the Clerk of the Circuit Court of Cook County, Richard J. Daley Center, 50 West Washington Street, Chicago, Illinois 60602. Please select the method you wish to be notified of your attorney code: ‰ Email ‰ Fax ‰ Mail Please print legibly. Status: NEW ATTORNEY CODE: ‰ Firm ‰ Individual Firm Name: _________________________________________________________________________________________ (As it will appear on the electronic docket) Attorney Name: ______________________________________________________________________________________ (First, Middle, Last, as it appears on your ARDC card -As it will appear on the electronic docket) Street Address: _______________________________________________________________________________________ City, State:________________________________________________________________ Zip Code: __________________ Telephone Number: (_______) _____________________________ Fax Number: (_______) ___________________________ Email: ______________________________________________ ARDC Number: __________________________________ CHANGE OF CONTACT INFORMATION: Status: ‰ Firm ‰ Individual Cook County Firm or Individual Attorney Code: __________________________________________________________ Firm Name: _________________________________________________________________________________________ (As referenced on previous Request Form) Attorney Name: ______________________________________________________________________________________ (As referenced on previous Request Form) Street Address: _______________________________________________________________________________________ City, State:________________________________________________________________ Zip Code: __________________ Telephone Number: (_______) _____________________________ Fax Number: (_______) ___________________________ Email: ______________________________________________ ARDC Number: __________________________________ REQUESTOR (must be completed if this is a firm request): Date: _________________________ __________________________________________________________ Requestor ARDC Number (if a firm request): _________________________________________________ Requestor (if a firm request): Office Use Only ‰ Attorney Code: _____________ ‰ Attorney Code information changed. ‰ Attorney Notified Operator: _____________________________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS