IN THE CIRCUIT COURT OF THE_____________ JUDICIAL CIRCUIT ______________ COUNTY, ILLINOIS In the Interest of ) ___________________________________, ) Petitioner. ) No. _______________ PETITION TO EXPUNGE JUVENILE RECORD (Category 1) Now comes _____________________________, Petitioner, pursuant to 705 ILCS 405/5915(1) and respectfully requests that this Honorable Court enter an order expunging all juvenile law enforcement and court records of petitioner and in support thereof states that: Petitioner has attained the age of 17, his/her birth date being __________, or all juvenile court proceedings relating to the Petitioner have been terminated as of __________________, whichever occurred later. Petitioner was arrested on _______________ by the _____________________ Police Department for the offense of ___________________________________________, and: (Check one:) D. E. was charged with an offense, but was found not delinquent of that offense; OR a petition was filed and the petition was dismissed without a finding of delinquency on _______________________; OR on ____________________ was placed under supervision pursuant to Section 5615 of the Juvenile Court Act of 1987 and such order of supervision has been successfully terminated on __________________________; OR G C. no Petition for delinquency was filed with the Clerk of the Circuit Court; OR G B. G G G A. was adjudicated for the offense, which would be a class B misdemeanor, a Class C misdemeanor, or a petty offense or business offense if committed by an adult. Petitioner has/has not been arrested on charges in this or any county other than the charges listed above. If Petitioner has been arrested on additional charges, please list the charges below: Charge(s):_______________________________________________________________ Arresting Agency/Agencies:_________________________________________________ 1 American LegalNet, Inc. www.USCourtForms.com Disposition/Result: (choose from A through E, above)____________________________ ________________________________________________________________________ WHEREFORE, the Petitioner respectfully requests this Honorable Court (1) to order all law enforcement agencies to expunge all records of petitioner to this incident, and (2) to order the clerk of the Court to expunge all records concerning the Petitioner regarding this incident. __________________________________________ Petitioner __________________________________________ Petitioner’s Street Address __________________________________________ City, State, Zip Code __________________________________________ Petitioner’s Telephone Number VERIFICATION BY CERTIFICATION Pursuant to the penalties of perjury under the Code of Civil Procedure, 735 ILCS 5/1-109, I hereby certify that the statements in this petition are true and correct, or on information and belief I believe the same to be true. Dated: _____________________ ____________________________________ Petitioner 2 American LegalNet, Inc. www.USCourtForms.com