Print Form Summons In Administrative Review Clear Form (5/4/01) CCG 0124 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS MUNICIPAL DEPARTMENT _________ DISTRICT _____________________________________________________ No: ___________________________________ Plaintiff vs Court Date: ____________________________ _____________________________________________________ Room:_________________________________ Defendant Court Time: ____________________________ Village/Township of _____________________________________ Department of Administrative Hearings _____________________________ Department SUMMONS IN ADMINISTRATIVE REVIEW To each Defendant: YOU ARE HEREBY SUMMONED and required to file an answer in this case or otherwise file your appearance within 35 days after the date of this summons, in the Office of the Clerk of the Circuit Court Located at: Richard J. Daley Center, Room 1111, Chicago, IL 60602 District 3: 2121 Euclid, Rolling Meadows, IL 60008 District 5: 10220 S. 76th Ave., Bridgeview, IL 60455 WITNESS _______________________________, ________ District 2: 5600 Old Orchard Rd., Skokie, IL 60077 District 4: 1500 Maybrook Dr., Maywood, IL 60153 District 6: 16501 S. Kedzie Pkwy., Markham, IL 60426. _______________________________________________ Clerk of Court Plaintiff Name: ____________________________________________________________________________________ Address: _________________________________________________________________________________________ Telephone (_________) _________________________ Facsimile Telephone (_________) _______________________ CERTIFICATE OF SERVICE I, ________________________________________, certify under penalties as provided in 735 ILCS 1-109 that I served the following parties by registered or certified mail on ______________________________, __________ ________________________________ , __________ _______________________________________ Signature SERVICE LIST 1. Village of: ____________________________________________________________________________________ 2. Other: ______________________________________________________________________________________ ____________________________________________________________________________________________