Free CCDR 0056 6-19-07.pmd - Illinois

4343 - Voluntary Enrollment in Alcohol Monitoring Program Petitioner - Allowed 4344 - Voluntary Enrollment in Alcohol Monitoring Program Respondent - Allowed 4406 - Case set on Progress Call

Voluntary Order for Enrollment in Alcohol Monitoring Program

(6/19/07) CCDR 0056 A

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION IN RE THE MARRIAGE VISITATION CUSTODY PARENTAGE OF

________________________________________________
PETITIONER AND

________________________________________________
RESPONDENT

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NO: _______________________________ CALENDAR: _______________________

PREJUDGMENT POST JUDGMENT

VOLUNTARY ORDER FOR ENROLLMENT IN ALCOHOL MONITORING PROGRAM
THIS CAUSE being properly before the Court, and the Court being advised in the premises, and the Petitioner/Respondent voluntarily submitting to alcohol monitoring; IT IS HEREBY ORDERED that: 1. _______________________________________________________________________________________
(Name of Company) (Address) (Telephone/FAX)

is designated as the alcohol monitoring program for

Petitioner

Respondent.

2. Petitioner/Respondent is hereby ordered to contact the above monitoring company within 24 hours of this Order to enroll in the alcohol monitoring program. 3. Petitioner /Respondent shall participate in the alcohol monitoring program as follows:

________________________________________________________________________________________ ________________________________________________________________________________________
4. The Court finds that the parties have limited financial means and qualify for the program's sliding scale fee schedule. The Court finds that the parties have sufficient resources to pay the program's costs.

5. The costs for Petitioner's/Respondent's participation shall be paid __________ % by Petitioner and __________ % by Respondent. 6. The monitoring company shall provide copies of any and all results to the Court, to pro se litigant(s) and to all attorney(s) of record. (OVER) DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

(6/19/07) CCDR 0056 B 7. Identification of Parties, Attorneys and Child Representatives: Petitioner: Petitioner's Attorney:

Name: _______________________________________ Atty. No. ______________ Address: _____________________________________ Name: _____________________________________________

_____________________________________________ Date of Birth: _________________________________ Telephone (H): ________________________________ (W): ________________________________________
Respondent:

Address: _______________________________________

______________________________________________ Telephone: ______________________________________ FAX: _______________________________________
Respondent's Attorney:

Name: _______________________________________ Atty. No. ______________ Address: _____________________________________ Name: __________________________________________

_____________________________________________ Date of Birth: _________________________________ Telephone (H): ________________________________ (W): ________________________________________

Address: _______________________________________

______________________________________________ Telephone: ______________________________________ FAX: ___________________________________________

Child(ren)'s Representative/Guardian ad Litem/Attorney for Child: Name: _______________________________________ Address: _____________________________________

_____________________________________________ Telephone: ___________________________________ FAX: ________________________________________
8. This matter is set for status on _______________________________ at _________ m. in Room _________. 4406

_____________________________________________ ______________________________________________
Petitioner's Signature
Atty. No.:__________________

Date

Respondent's Signature

Date

____________________________________ Atty. for: ____________________________________ ENTERED: Address: ____________________________________ Dated: ______________________________, ___________ City/State/Zip: __________________________________ Telephone: __________________________________ _____________________________________________ FAX: ____________________________________ Judge Judge's No.
Name: DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS