Free 351.006 4-21-09.pmd - Illinois

Cook County Attorney Code Request Form

(Rev. 4/21/09) 351*006

COOK COUNTY ATTORNEY CODE REQUEST FORM
Please complete the information requested below. Indicate whether this request is for a firm or individual attorney code. Also indicate whether the request is for a new attorney code or change of contact information. If you are requesting a firm attorney code, an attorney in that firm must provide his/her documentation as described below. NOTE: NAME INFORMATION CANNOT BE CHANGED! Documentation needed: All requests must be accompanied by copies of your current and valid Illinois Attorney Registration & Disciplinary Commission (ARDC) card AND your valid government-issued driver's license or identification card. If you are an out-of-state attorney not licensed to practice law in Illinois, please contact (312) 603-5469 for further information. (NOTE, YOUR APPLICATION WILL NOT BE PROCESSED WITHOUT YOUR ARDC INFORMATION.) Requests, except for those in person, will be processed from 9:00 a.m. to 3:00 p.m., Monday through Friday, excluding court holidays. REQUESTS RECEIVED AFTER 3:00 p.m. WILL BE PROCESSED ON THE FOLLOWING BUSINESS DAY. You may submit this request any of the following ways: 1. 2. 3. Via facsimile: Fax your completed request and copies of the above supporting documents to (312) 603-3348. Via email: Email your completed request and copies of the above supporting documents to [email protected]. In person: Bring your completed request along with the original supporting documents to the Law Division in Room 801 of the Richard J. Daley Center, 50 West Washington Street, Chicago, Illinois 60602 or the Civil Department at any of the Suburban Districts (processed 8:30 a.m. to 4:30 p.m., entire business day). Via U.S. Mail: Mail your completed request and copies of the above supporting documents to the Law Division in Room 801 of the Clerk of the Circuit Court of Cook County, Richard J. Daley Center, 50 West Washington Street, Chicago, Illinois 60602. Email Fax Mail

4.

Please select the method you wish to be notified of your attorney code: Please print legibly. NEW ATTORNEY CODE: Status:

Firm

Individual

Firm Name: _________________________________________________________________________________________
(As it will appear on the electronic docket)

Attorney Name: ______________________________________________________________________________________
(First, Middle, Last, as it appears on your ARDC card -As it will appear on the electronic docket)

Street Address: _______________________________________________________________________________________ City, State:________________________________________________________________ Zip Code: __________________ Telephone Number: (_______) _____________________________ Fax Number: (_______) ___________________________ Email: ______________________________________________ ARDC Number: __________________________________ CHANGE OF CONTACT INFORMATION: Status: Firm Individual

Cook County Firm or Individual Attorney Code: __________________________________________________________ Firm Name: _________________________________________________________________________________________
(As referenced on previous Request Form)

Attorney Name: ______________________________________________________________________________________
(As referenced on previous Request Form)

Street Address: _______________________________________________________________________________________ City, State:________________________________________________________________ Zip Code: __________________ Telephone Number: (_______) _____________________________ Fax Number: (_______) ___________________________ Email: ______________________________________________ ARDC Number: __________________________________ REQUESTOR (must be completed if this is a firm request): Date: _________________________

__________________________________________________________ Requestor ARDC Number (if a firm request): _________________________________________________
Requestor (if a firm request): Office Use Only Attorney Code: _____________ Attorney Code information changed. Attorney Notified Operator: _____________________________

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