Print Form Clear Form 2118 2119 Summons Served by Special Process Server Summons Not Served by Special Process Server (8/19/08) CCCH N061 Affidavit of Special Process Server IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS ____________________________________________ DEPARTMENT, ______________________________________ (County) (Municipal) (Division) (District) CASE NO. ________________________________ AFFIDAVIT OF SPECIAL PROCESS SERVER __________________________________________________________ being first duly sworn on oath deposes and states that s/he was appointed by the Court on ___________________________, __________ to serve process in the above mentioned cause. The following individuals were SERVED / NOT SERVED with summons and a copy of the complaint: Named Defendant (S) Served / (N) Not Served (S) ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ 2118 2118 2118 2118 2118 2118 2118 2118 2118 (N) 2119 2119 2119 2119 2119 2119 2119 2119 2119 Substitute Service Date of Service (of the age of 13 or upwards) ________________________________________________________________________________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ Date: ________________________________, __________ ________________________________________________ Special Process Server Signature Signed and sworn before me on this __________________ day of _____________________________________, __________ __________________________________ Notary public DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS