Print Form Affidavit in Support of a Disposition of Supervision Clear Form (6/14/10) CCTR 0032 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS MUNICIPAL DEPARTMENT, ____________ DISTRICT The People of the State of Illinois or City/Village of _____________________________ a municipal corporation, v. _________________________________________ Defendant. } Case No. _______________________________ _______________________________________ _______________________________________ AFFIDAVIT IN SUPPORT OF A DISPOSITION OF SUPERVISION I certify the following statement to be true: I have not been placed on supervision by a judge in court, through an electronic plea of guilty or through a mailed-in plea of guilty for violating any law that governs the movement of vehicles (traffic offenses) under the Illinois Vehicle Code or a similar provision of a local ordinance more than one time during the 12-month period before the date of the ticket(s) issued to me in this case. I understand I am not eligible for supervision if any courts have granted me supervision two or more times during the 12-month period before the date on the ticket(s) in this case. I also understand that a disposition of supervision shall include mandatory court fees and costs, and may include fines. Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, I certify that the statements set forth in this affidavit are true and correct. _________________________________________ Defendant's Signature _________________________________________ PRINT NAME DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS