UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF LASALLE IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT vs. Case No SUMMONS TO THE DEFENDANT: YOU ARE HEREBY SUMMONED and required to file an answer in this case, or otherwise file your appearance, in the office of the clerk of this court, Room 201, 119 W. Madison Street, Ottawa, Illinois, within 30 days after service of this summons, not counting the day of service. IF YOU FAIL TO DO SO, A JUDGMENT OR DECREE BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE RELIEF ASKED IN THE COMPLAINT. TO THE OFFICER: This summons must be returned by the officer or other person to whom it was given for service, with endorsement of service and fees, if any, immediately after service. If service cannot be made, this summons shall be returned so endorsed. This summons may not be served later than 30 days after its date. Witness, _____________________, __________ Name Attorney for Address City Telephone Clerk of Court (Seal of Court) Date of Service ______________________, ______ (To be inserted by officer on copy left with defendant or other person) LASALLE COUNTY CIRCUIT CLERK OTTAWA, ILLINOIS 61350 American LegalNet, Inc. www.FormsWorkflow.com GENSUMN(09/00) SHERIFF’S FEES Service and return.......................................... $ Miles .................................................. Total.............................................................. $ Sheriff of County I certify that I served this summons on defendants as follows: (Check appropriate box, and complete information below) (a)--Individual defendants--personal): By leaving a copy and a copy of the complaint with each individual defendant personally. (b)--(Individual defendants--abode): By leaving a copy and a copy of the complaint at the usual place of abode of each individual defendant with a person of his family, of the age 13 years or upwards, informing that person of the contents and also by sending a copy of the summons in a sealed envelope with postage fully prepaid, addresses to each individual defendant at his usual place of abode. (c)--(Corporation defendants): By leaving a copy and a copy of the complaint with the registered agent, officer or agent of each defendant corporation. (d)--(Other service): Name of Defendant Name of Defendant Name of Person Summons Given to Name of Person Summons Given to Sex Race Approx. Age Date of Mailing Race Approx. Age Place of Service Place of Service Date of Service Sex Time Date of Service Time Date of Mailing American LegalNet, Inc. www.FormsWorkflow.com