CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT 251 WHEATON, ILLINOIS 60187-0707 File Stamp Here2348 (Rev. 5/15)AFFIDAVIT OF DAMAGESvsAFFIDAVIT OF DAMAGES SUPREME COURT RULE 222CASE NUMBER The undersigned being first duly sworn upon oath, deposes and states that he / she is a party to the above entitled cause of action seeking money damages or collection of taxes and states that this cause of actionUNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT does not exceed $50,000.00 does exceed $50,000.00 Sworn and Subscribed before me Date Notary Public / Circuit Court Clerk American LegalNet, Inc. www.FormsWorkFlow.com