Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinoiscookcountyclerkofcourt.orgPage 1 of 32145 - Served2245 - Not ServedSummons to Respondent Worker222s Compensation Review þ (08/06/18) CCL 0037 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOISCOUNTY DEPARTMENT, LAW DIVISION þ v.Illinois Workers222 Compensation Commissionof Illinois and þ Case No. þ þ SUMMONS TO RESPONDENT WORKER222S COMPENSATION REVIEW To þ , respondent, and þ attorney for respondent.before* þ þ Workers222 Compensation Commission of Illinois rendered on þ , for þ against þ IF YOU FAIL TO DO SO, THE DECISION OR AWARD MAY BE REVERSED.org American LegalNet, Inc. www.FormsWorkFlow.com Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinoiscookcountyclerkofcourt.orgPage 2 of 3 Witness: þ þ þ þ * þ 10 to 60 days from date of issuance of this summons. Atty. No.: þ Atty Name: þ þ Atty. for: þ þ Address: þ þ City: þ þ State: þ þ Zip: þ þ Primary Email: þ þ Summons to Respondent Worker222s Compensation Review þ (08/06/18) CCL 0037 B American LegalNet, Inc. www.FormsWorkFlow.com Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinoiscookcountyclerkofcourt.orgPage 3 of 3 þ þ þ þ þ þ þ þ þ þ þ 1500 Maybrook Ave þ þ þ þ þ þ þ þ þ 555 W Harrison þ þ þ þ þ Criminal Court Building þ þ Daley Center Divisions/Departments þ Civil Division þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Civil Appeals þ þ þ þ þ Criminal Department þ þ þ þ þ County Division þ þ þ þ þ Probate Division þ þ þ þ þ þ þ þ þ þ þ þ þ þ CLERK OF THE CIRCUIT COURT OF COOK COUNTY OFFICE LOCATIONS American LegalNet, Inc. www.FormsWorkFlow.com