2211 - 1 (Rev. 01/09) CITATION TO DISCOVER ASSETS - (3rd PARTY) STATE OF ILLINOIS UNITED STATES OF AMERICA IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT COUNTY OF DU PAGE PLAINTIFF vs CASE NUMBER THIRD PARTY CITATION TO DISCOVER ASSETS DEFENDANT CITATION THIRD PARTY RESPONDENT File Stamp Here To: Name and Address of Defendant or Third Party Respondent YOU ARE COMMANDED to appear before the presiding Judge in Courtroom Center, 505 N. County Farm Rd., Wheaton, Illinois on located at the DuPage County Judicial at to be examined under oath concerning the property or income or indebtedness due A Judgment in favor of . and against (Judgment Debtor) was entered on and $ remains unsatisfied. YOU ARE COMMANDED to produce at the examination (bring with you) all books, papers, or records in your possession or over which you have control, which may contain information concerning the property of Judgment debtor which indicates that you are indebted to or holding any funds for the Judgment debtor, including: You are prohibited from making or allowing any transfer or other disposition of, or interfering with, any property not exempt from the enforcement of a judgment therefrom, a deduction order or garnishment, belonging to the judgment debtor or to which he or she may be entitled or which may thereafter be acquired by or become due to him or her, and from paying over or otherwise disposing of any moneys not so exempt which are due or to become due to the judgment debtor, until the further order of the court or the termination of the proceeding whichever occurs first. The third party may not be obliged to withhold the payment on any moneys beyond double the amount of the balance due sought to be enforced by the judgment creditor. WARNING YOUR FAILURE TO APPEAR IN COURT AS HEREIN DIRECTED MAY CAUSE YOU TO BE ARRESTED AND BROUGHT BEFORE THE COURT TO ANSWER A CHARGE OF CONTEMPT OF COURT, WHICH MAY BE PUNISHABLE BY IMPRISONMENT IN THE COUNTY JAIL. YOUR FAILURE TO COMPLY WITH THE CITATION PROCEEDING MAY RESULT IN A JUDGMENT BEING ENTERED AGAINST YOU FOR THE UNSATISFIED AMOUNT OF THE JUDGMENT (735 ILCS 5/2-1402(c)(1)) CERTIFICATE OF ATTORNEY OR JUDGMENT CREDITOR Judgment Amount: Balance Due: Date of Judgment/Revival: Case Number: Name of Court Entering Judgment: The undersigned, certifies under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the information contained is true and correct. Signature Name: DuPage Attorney Number: Attorney for: Address: PRO SE WITNESS: CHRIS KACHIROUBAS, Clerk of the Eighteenth Judicial Circuit Court, and the seal thereof, Wheaton, lllinois Date City/State/Zip: Telephone Number: Clerk of the Eighteenth Judicial Circuit CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 American LegalNet, Inc. www.FormsWorkflow.com 2211 - 2 (Rev. 01/09) CITATION TO DISCOVER ASSETS - 3rd PARTY THIRD PARTY RESPONDENT ANSWER TO CITATION TO DISCOVER ASSETS Hearing Date Case Number Citation Respondent , certifies under penalty of perjury that with regard to the property of the judgment debtor, the Citation Respondent files the following answer to this Citation to Discover Assets and is in possession of the following property of the judgment debtor. Select one or more of the following and the indicate the amount held A. Savings Account Amount held $ B. Checking and / or Now Account Amount held $ C. Certificate of Deposit Amount held $ D. Money Market Account Amount held $ E. Trust Account Amount held $ F. Safety Deposit Box $ G. Wages, Salary or Commissions $ H. No Accounts I. Other Personal Property (describe) $ (Attach an additional sheet if necessary) Less right of offset for other loans $ Less deduction for fees limited by 205 ILCS 5/48.1 $ Sub-Total Total $ J. Adverse Claimant Name Address According to the business records kept by the Citation Respondent, we show the above information to be correct. Citation Respondent or Agent for Citation Respondent (must type or print) Name: Business Name Citation Respondent or Agent for Citation Respondent Address: City/State/Zip: Telephone Number: Date Note: A copy of this Answer should be mailed to the Circuit Court Clerk, Attorney for Plaintiff or Judgment Creditor, Defendant CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 American LegalNet, Inc. www.FormsWorkflow.com