This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts. EX - DO 2906.3 Page 1 of 1 ( 0 9 / 18 ) STATE OF ILLINOIS, ORDER DENYING REQUEST TO EXPUNGE & IMPOUND AND/OR SEAL CRIMINAL RECORDS For Court Use Only CIRCUIT COURT COUNTY Instructions Directly above, enter the name of county where you will file the case. Request of: Enter your name, birth date, race, and gender. List any other names you used when arrested on the cases listed on this form. Your name (First, middle, last name) Other names used in these cases If the Clerk gave you a new case number, enter it to the right. Date of birth Race Gender Case Number (if the Clerk assigns a new number) IT IS ORDERED: DO NOT fill in these lines. The judge will fill out and check the correct boxes. Your Request is DENIED for all cases sought to be expunged; OR Your Request is DENIED for the following cases: The reason your Request is denied for these cases : (check all that apply) Your records are not legally eligible to be expunged . You failed to attach the required drug test. The c ourt f inds that the public222s interest in retaining your criminal records is greater than your interest in expunging your records. Other: IT IS ORDERED: DO NOT fill in these lines. The judge will fill out and check the correct boxes. Your Request is DENIED for all cases sought to be sealed; OR Your Request is DENIED for the following cases: The reason your Request is denied for these cases : (check all that apply) Your records are not legally eligible to be sealed . You failed to attach the required drug test. The c ourt f inds that the public222s interest in retaining your criminal records is greater than your interest in sealing your records. Other: DO NOT fill in these lines. The judge will sign and enter date here. ENTERED: Judge : Date: Enter the name and contact information of the person completing the Order. Prepared by: Street Address: Phone Number: City, State, ZIP: Email Address : American LegalNet, Inc. www.FormsWorkFlow.com