STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE ____________ JUDICIAL CIRCUIT ____________________ COUNTY __________________________, ) ) Plaintiff, ) ) vs. ) No. ____-- __ --____ ) __________________________, ) ) Defendant. ) CERTIFICATE OF MAILING OF ORDER FOR PAYMENT I, _______________________, hereby certify that I mailed a copy of the O rder For Payment to ________________________ at _____________________ by depositi ng the same in the United States mail at _______________________, Illinois, pos tage fully prepaid on ________________, 20____. ______________________, ___________ Under penalties as provided by law pursuant to Section 5/1-109 of the Co de 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 informati on and belief and as to such matters the undersigned certifies as aforesaid that she/he verily b elieves the same to be true. ______________________, ___________ _______________________ _______________________ _______________________ American LegalNet, Inc. www.USCourtForms.com