(This form replaces CCG 34) (Rev. 1/19/01) CCTR 0616 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS MUNICIPAL DISTRICT ___________ ! People of the State of Illinois ! City/Village of __________________________________________ vs. Name: ___________________________________________________ Address: _________________________________________________ City/Zip: _________________________________________________ Ticket No. ________________________________ PETITION FOR VIOLATION OF SUPERVISION 1. On _________________________, ________ the defendant was placed on supervision for a violation of the Illinois Vehicle Code and/or Local Ordinance relating to the movement of traffic. 2. As condition of that order, the defendant was required to pay fines and costs totaling $ _________________. 3. That there remains due and owing the sum of $ _________________, payment of which the defendant willfully refuses to pay. 4. That such willful failure to pay is a violation of supervision. WHEREFORE, the Plaintiff requests notice be sent to the defendant scheduling a hearing on this petition revoking the order of supervision, entering a judgment of conviction, and assessing additional fines and costs. _______________________________________________ Prosecutor NOTICE TO DEFENDANT Hearing on this Petition is scheduled for __________________________, ________, in Courtroom __________ at ___________ am/pm, at the courthouse location checked below. YOUR PRESENCE IS REQUIRED. ! District 1 -Traffic Violations Bureau 50 W. Washington Chicago, IL 60602 ! District 2 - Skokie 5600 Old Orchard Rd. Skokie, IL 60077 ! District 3 - Rolling Meadows 2121 Euclid Rolling Meadows, IL 60008 ! District 4 - Maywood 1500 Maybrook Ave. Maywood, IL 60153 ! District 5 - Bridgeview 10220 S. 76th Ave. Bridgeview, IL 60455 District 6 - Markham 16501 S. Kedzie Pkwy. Markham, IL 60426 ! _____________________________________________ Presiding (Supervising) Judge I, _________________________________________, deputy clerk of the Circuit Court of Cook County, Illinois, states under penalties of perjury as defined in Section 1-109 of the Code of Civil Procedure, that the above Petition for Violation of Supervision was served by depositing same in the U.S. Mail on the ________ day of ______________________, _______. _____________________________________________ Deputy Clerk AVOID A COURT APPEARANCE Within 10 days of this notice you may pay, to the Clerk of the Circuit Court, in person or by mail, the sum of $ _____________________. DO NOT MAIL CASH. USE MONEY ORDER FOR MAIL PAYMENT. PERSONAL CHECKS NOT ACCEPTED. Payment may be made ONLY in person or by mail at the Office of the Clerk of the Circuit Court checked above. PLEASE WRITE TICKET NUMBER ON MONEY ORDER. THIS IS THE ONLY NOTICE YOU WILL RECEIVE. DO NOT MAIL CASH. Failure to pay the sum now due or appear in court on the scheduled date may cause the following: 1. A judgment of conviction being entered and forwarded to the Secretary of State; 2. An increase in the fine to the maximum fine set by law, plus assessment of court costs; 3. Issuance of a warrant for your arrest. Dorothy Brown CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS