STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT BOONE COUNTY, ILLINOIS Plaintiff(s) vs. Case No. Amount Claimed Defendant(s) THIS IS AN ARBITRATION CASE SUMMONS (Arbitration) To each Defendant: YOU ARE SUMMONED AND REQUIRED TO APPEAR BEFORE THIS COURT on at in courtroom of the Boone County Courthouse, 601 N. Main St., Belvidere, IL, 61008 to answer the Complaint in this case, a copy of which is attached hereto. IF YOU FAIL TO DO SO, A JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE RELIEF ASKED IN THE COMPLAINT. E-filing is now mandatory for documents in civil cases with limited exemptions. To e-file, you must first create an account with an e-filing service provider. Visit http://efile.illinoiscourts.gov/service-providers.htm to learn more and to select a service provider. If you need additional help or have trouble e-filing, visit http://www.illinoiscourts.gov/FAQ/gethelp.asp , or talk with your local circuit clerk222s office. NOTICE TO THE PLAINTIFF: If you fail to appear on the date set for return shown above, the case will be dismissed for want of prosecution. IF THIS SUIT INVOLVES A CLAIM IN TORT, SUPREME COURT RULE 222 DISCLOSURE STATEMENT MUST BE ATTACHED TO THE COMPLAINT. To the officer: This summons must be returned by the officer or other person to whom it was given for service, with endorsement of service and fees, if any, immediately after service. This summons may not be served later than three (3) days before the day for appearance. If service cannot be made, this summons shall be returned so endorsed. This summons may not be served later than 30 days after its issuance. WITNESS Clerk of the Circuit Court Court Seal By: Deputy Clerk (Plaintiff222s attorney or plaintiff if not represented by an attorney) Name Prepared by Attorney for Attorney Registration No. Address ARDC No. City, State, Zip Email Address Telephone Date of Service (To be inserted by office on copy left with the employer or other persons) NOTICE TO PLAINTIFF OR PLAINTIFF222S ATTORNEY: When preparing the above summons, the return date, which will be not less than 21 nor more than 40 days after the date of issuance of summons, will be set by the Clerk of the Court at the time of filing of the Complaint. If you have a disability that requires an accommodation to participate in court, please contact the Court Disability Coordinator at 815-319-4806 File Stamp Summons - Arbitration 7/19/18 American LegalNet, Inc. www.FormsWorkFlow.com SHERIFF222S FEES Service and return $ Miles $ Total Sheriff222s Fees $ Sheriff of County I certify that I served this summons on defendants as follows: (a) - INDIVIDUAL DEFENDANTS - PERSONAL: The officer or other person making service, shall (a) identify as to sex, race and approximate age of the defendant with whom he left the summons, and (b) state the place where (whenever possible in terms of an exact street address) and the date and time of the day when the summons was left with the defendant. (b) - INDIVIDUAL DEFENDANTS - ABODE: By leaving a copy of the summons and a copy of the complaint at the usual place of abode of each individual defendant with a person of his family, of the age of 13 years and upwards, informing that person of the contents of the summons. The officer or other person making service, shall (a) identify as to sex, race and approximate age of the person, other than the defendant with whom he left the summons, and (b) state the place where (whenever possible in terms of an exact street address) and the date and time of day when the summons was left with such person. and also by sending a copy of the summons and of the complaint in a sealed envelope with postage fully pre-paid, addressed to each individual defendant at his usual place of abode, as follows: Name of Defendant Mailing Address Date of Mailing (c) - CORPORATION DEFENDANTS: By leaving a copy and a copy of the complaint with the registered agent, officer or agent of each defendant corporation, as follows: Defendant corporation Registered agent, officer or agent Date of Service (d) - OTHER SERVICE , Sheriff of County By: (Deputy) American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO DEFENDANT (A) This case will not be heard on the day for appearance specified on the reverse side, hereafter called the return date. (B) If the Complaint is verified (sworn to), your Answer must be verified. (C) If you have not obeyed this Summons and filed a written Appearance or Answer before the return day, an Order of Default and Judgment may be taken against you on the return day. (D) If you have filed a written Appearance on or before the return day, you musts file an Answer not later than 10 days after the return day. If you fail to file an Answer within that time, an Order of Default and Judgment may be taken against you at any time after said 10 days. (E) If you have filed a written Appearance or Answer on or before the return day, you must appear on the return date for setting of the arbitration hearing. (F) Late filing of an Appearance or Answer will not relieve you from judgment or default order except by court order. American LegalNet, Inc. www.FormsWorkFlow.com