This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts.
For Court Use Only
STATE OF ILLINOIS,
ORDER DENYING REQUEST TO
CIRCUIT COURT
EXPUNGE & IMPOUND AND/OR
COUNTY
SEAL CRIMINAL RECORDS
Instructions
Directly above, enter
Request of:
the name of county
where you will file the
case.
Your name
(First, middle, last name)
Enter your name, birth
date, race, and gender.
List any other names
you used when
Other names used in these cases
arrested on the cases
listed on this form.
If the Clerk gave you
a new case number,
Date of birth
Race
Gender
Case Number
(if the Clerk
enter it to the right.
assigns a new number)
IT IS ORDERED:
DO NOT fill in these
Your Request is DENIED for all cases sought to be expunged; OR
lines. The judge will fill
Your Request is DENIED for the following cases:
out and check the
correct boxes.
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 court finds that the public’s interest in retaining your criminal records is greater
than your interest in expunging your records.
Other:
IT IS ORDERED:
DO NOT fill in these
Your Request is DENIED for all cases sought to be sealed; OR
lines. The judge will fill
Your Request is DENIED for the following cases:
out and check the
correct boxes.
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 court finds that the public’s interest in retaining your criminal records is greater
than your interest in sealing your records.
Other:
DO NOT fill in these
ENTERED:
lines. The judge will
sign and enter date here.
Judge:
Date:
Prepared by:
Enter the name and
contact information of
Street Address:
Phone Number:
the person completing
City, State, ZIP:
Email Address:
the Order.
EX-DO 2906.3
Page 1 of 1
(09/18)
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This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts.
For Court Use Only
STATE OF ILLINOIS,
ORDER DENYING REQUEST TO
CIRCUIT COURT
EXPUNGE & IMPOUND AND/OR
COUNTY
SEAL CRIMINAL RECORDS
Instructions
Directly above, enter
Request of:
the name of county
where you will file the
case.
Your name
(First, middle, last name)
Enter your name, birth
date, race, and gender.
List any other names
you used when
Other names used in these cases
arrested on the cases
listed on this form.
If the Clerk gave you
a new case number,
Date of birth
Race
Gender
Case Number
(if the Clerk
enter it to the right.
assigns a new number)
IT IS ORDERED:
DO NOT fill in these
Your Request is DENIED for all cases sought to be expunged; OR
lines. The judge will fill
Your Request is DENIED for the following cases:
out and check the
correct boxes.
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 court finds that the public’s interest in retaining your criminal records is greater
than your interest in expunging your records.
Other:
IT IS ORDERED:
DO NOT fill in these
Your Request is DENIED for all cases sought to be sealed; OR
lines. The judge will fill
Your Request is DENIED for the following cases:
out and check the
correct boxes.
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 court finds that the public’s interest in retaining your criminal records is greater
than your interest in sealing your records.
Other:
DO NOT fill in these
ENTERED:
lines. The judge will
sign and enter date here.
Judge:
Date:
Prepared by:
Enter the name and
contact information of
Street Address:
Phone Number:
the person completing
City, State, ZIP:
Email Address:
the Order.
EX-DO 2906.3
Page 1 of 1
(09/18)
PRINT FORM
SAVE FORM
RESET FORM
