CERTIFICATE OF DEFAULT (Rev. 1/18/01) CCCH 0056 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS __________________________________________________ Petitioner vs. No. ______________________ __________________________________________________ Respondent CERTIFICATE OF DEFAULT I, ____________________________________________, Attorney for _____________________________________, file for this case, and on _______________________________________, ________, I checked the registrar for this case. I further certify the proof of service of summons shows that the following parties have been served on the dates indicated as follows: PARTY - Type of Service (Personal, Member of household, Publication, or other) Describe.* DATE OF SERVICE ________________________________________________ _____________________________ ________________________________________________ _____________________________ ________________________________________________ _____________________________ I further certify that the only appearances filed of record, were for the following persons and on the dates shown herein: PARTY* DATE OF APPEARANCE ________________________________________________ ______________________________ ________________________________________________ ______________________________ ________________________________________________ ______________________________ and that all other parties to this cause have failed to file their appearance. Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he/she verily believes the same to be true. _________________________________ Name _________________________________ Address _________________________________ Phone *Use additional sheets if necessary. DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Print This Form For your protection and privacy, please press the Clear This Form button after you have printed the form. Clear This Form