American LegalNet, Inc. www.FormsWorkflow.com STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT KANE COUNTY, ILLINOIS THIS IS AN ARBITRATION CASE Case No. Plaintiff(s) Defendant(s) Plaintiff(s) Atty. Defendant(s) Atty. Judge A copy of this order Plaintiff Atty. Court Reporter should be sent has been sent Defense Atty. Deputy Clerk Other File Stamp SUPREME COURT RULE 222 ARBITRATION DISCLOSURE STATEMENT Instructions: Complete this disclosure statement using all of the information available to you within the time specified in Supreme Court Rule 222(c) and as set forth by local rule, or as the Court may order. File this Disclosure Statement with the Circuit Clerk and provide a copy to every party to the action. You are under a continuing duty to disclose. You must seasonably supplement or amend this disclosure statement whenever new or different information or documents become known to you. All disclosures shall include information and data in the possession, custody, and control of the parties, as well as that which can be ascertained, learned, or acquired by reasonable inquiry and investigation. Each disclosure must be accompanied by a completed Affidavit of Disclosure. EACH PARTY SHALL DISCLOSE IN WRITING TO EVERY OTHER PARTY: 1. The factual basis of the claim or defense. If multiple claims or defenses, the factual basis for each claim or defense. 2. The legal theory upon which each claim or defense is based, including, where necessary for a reasonable understanding of the claim or defense, citations of pertinent legal or case authorities. 3. Names, addresses, and telephone numbers of any witnesses you expect to call at the arbitration hearing/trial, including the subject matter on which they will testify. 4(a). Names, addresses, and telephone numbers of all persons whom the party believes may have knowledge or information relevant to events, transactions or occurrences that gave rise to the action. 4(b). The nature of the knowledge or information each such individual is believed to possess. AR-010 (12/08) Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com Case No. 5. Names, addresses, and telephone numbers of all persons who have given statements, whether written or recorded, signed or unsigned, and the custodian of the copies of those statements. 6. Names, addresses, and telephone numbers of each person you expect to call as an opinion witness at the arbitration hearing/trial; the subject matter of their testimony; their conclusions and opinions and bases therefore; their qualifications; and copies of any reports prepared by them. 7. A computation and the measure of damages you allege; the document or testimony on which the computation and measure are based; and the names, addresses, and telephone numbers of all damage witnesses. 8. The existence, location, custodian, and general description of any tangible evidence or documents that you plan to use at the arbitration hearing/trial and relevant insurance agreements. 9(a). A list of documents (if voluminous documents, a list of the categories of documents), you know to exist (whether or not in the party's possession, custody, or control), which may be relevant to the subject matter of the action, and which appear reasonably calculated to lead to the discovery of admissible evidence. 9(b). The dates when these documents will be made, or have been made, available for inspection and copying. For each copy of the Rule 222 Disclosure Statement sent to all other parties in the Action: ATTACH A COPY OF EACH DOCUMENT LISTED HEREIN, as it is kept in the usual course of business. If production is not made, list the name and address of the document's custodian. DO NOT ATTACH COPIES OF DOCUMENTS TO THE RULE 222 DISCLOSURE STATEMENT WHICH YOU FILE WITH THE COURT. AR-010 (12/08) Page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com Case No. STATE OF ILLINOIS IN THE CIRCUIT COURT FOR THE SIXTEENTH JUDICIAL CIRCUIT KANE COUNTY, ILLINOIS AFFIDAVIT OF DISCLOSURE (AFDD) being first duly sworn, on oath deposes and states that he/she has read the foregoing Disclosure Statement and that he/she knows the contents thereof, and that the same are complete and correct as of the date of this disclosure and that all reasonable attempts to comply with the provisions of Illinois Supreme Court Rule 222 have been made. SUBSCRIBED AND SWORN TO before me this (Date) Attorney/Party for Plaintiff/Defendant NOTARY PUBLIC Address Telephone NOTICE OF DISCLOSURE (ND) TO: PLEASE TAKE NOTICE that on , we served upon every other party to this action named herein, a copy of this Supreme Court Rule 222 Disclosure Statement, by mail and that a copy of this notice has been filed with the Clerk of the Circuit Court, Kane County, Illinois. By: Attorney/Party for Plaintiff/Defendant CERTIFICATE OF SERVICE (COS) I certify that on I served this Notice of Disclosure by mailing a copy of the same to each person to whom it is directed, as listed above and deposited the same in the U.S. Mail at before P.M. on this date with proper postage prepaid. SUBSCRIBED AND SWORN TO before me this (Date) Attorney/Party for Plaintiff/Defendant NOTARY PUBLIC AR-010 (12/08) Page 4 of 4 American LegalNet, Inc. www.FormsWorkflow.com