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Request For Notice To Medical Facilities And Schools CCG 0709 - Illinois
| Request For Notice To Medical Facilities And Schools Form. This is a Illinois form and can be used in General Cook Local County . |
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Print Form Clear Form OFFICE OF THE CIRCUIT COURT CLERK OF COOK COUNTY REQUEST FOR NOTICE TO MEDICAL FACILITIES AND SCHOOLS (PLEASE PRINT) __________________________________________________________ PETITIONER'S NAME (person requesting the Order of Protection) Case Number ________________________________ v. __________________________________________________________ RESPONDENT'S NAME (person the Order of Protection is against) As provided for in the Illinois Domestic Violence Act, 750 ILCS 60/222(e), I _____________________________________________, request that the Clerk of PETITIONER'S NAME the Circuit Court of Cook County issue a certified copy of the Order of Protection (see attached) entered on _________________________, __________, by Judge DATE ___________________________________________ to the following school(s) in which the child(ren) of the petitioner is/are enrolled: JUDGE'S LAST NAME JUDGE'S NO. IMPORTANT NOTE: If your children all attend the same school print the school's name, complete address, city and zip code ONLY once. If your children attend different schools, you must print the name, address, city and zip code of EACH SCHOOL. CHILD'S FULL NAME NAME OF SCHOOL SCHOOL STREET ADDRESS CITY ZIP CODE _______________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ ___________________________________________ ATTORNEY FOR PETITIONER __________________________________________ PETITIONER'S NAME _______________________ EXPIRATION DATE OF ORDER DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS (Rev. 11/18/11) CCG 0709
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