NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING 4207 (Rev 10/2011) COUNTY OF DU PAGE STATE OF ILLINOIS UNITED STATES OF AMERICA IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT PLAINTIFF/PETITIONER CASE NUMBER vs DEFENDANT/RESPONDENT File Stamp Here NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING Pursuant to Illinois Supreme Court Rule 138, the filer of a court record at the time of filing shall include a confidential information form which identifies the full social security numbers for any individuals whose social security numbers are redacted within the filing. This information will not be available to the public and this document will be stored in a separate location from the case file. Party/Individual Information: 1. Name: Address: Phone: SSN: 2. Name: Address: Phone: SSN: (Attach additional pages, if necessary.) CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 American LegalNet, Inc. www.FormsWorkFlow.com