Free CCG 0052 7-11-08.pmd - Illinois

Agreed Petition for Refund of Fees Collected IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

(Rev. 7/11/08) CCG 0052

______________________________________________________ v. ______________________________________________________

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No. _____________________________

AGREED PETITION FOR REFUND OF FEES COLLECTED
I, _____________________________________________, hereby petition this honorable Court to order the refund of certain fees and costs collected by the Clerk of the Circuit Court of Cook County. ________________________________________________ delivered $ ______________________________ in payment of fees and/or costs to the Clerk of the Circuit Court in payment of __________________________________________________ on ___________________________________, _________.

It has been determined that $ ___________________ of this payment was not due and owing to the Clerk of the Circuit Court. The petitioner hereby declares that the foregoing statements to be true and accurate.

____________________________________________ By ____________________________________________

ORDER
It is therefore ordered DOROTHY BROWN, Clerk of the Circuit Court pay to ______________________________ the amount of $ ______________________________ as a refund of the fees and/or costs. Atty. No.:__________________ Name: ______________________________________________ Atty. for: __________________________________________ Address: __________________________________________ City/State/Zip: ______________________________________ Telephone: ________________________________________ _______________________________________________ Judge Judge's No. _____________________________________, _________ ENTERED:

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS