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Answer To Citation To Discover Assets Proceeding Form. This is a Illinois form and can be use in Lake Local County.
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Tags: Answer To Citation To Discover Assets Proceeding, 171-351, Illinois Local County, Lake
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
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Plaintiff,
vs.
Defendant.
Case. No.
ANSWER TO CITATION TO DISCOVER ASSETS PROCEEDING
In answer to the Citation and supplemental proceedings served upon _________________________________________
he/she answers under oath as follows:
Name: _____________________________________________________
Home Address: ____________________________________________________________________________________
Home Phone: _______________________________________________ DL#: _________________________________
Date of Birth: _________________ I am
Single
Married
Divorced
Widowed
I have _________ dependents. List names and ages. ______________________________________________________
_________________________________________________________________________________________________
Employed?:
Yes
No
If yes, are you self-employed?
Yes
No
Company Name and Address:
_____________________________________________
_____________________________________________
_____________________________________________
Work Phone:___________________________________
Job Title: ______________________________________
I earn $ _____________ per ____________________
I do not have a job, but I support myself through:
Public Aid $ ______________________ per month
Unemployment $ __________________ per month
Social Security $ __________________ per month
SSI $ ___________________________ per month
Pension $ _______________________ per month
Other $ _________________________ per month
(list source) ___________________________________
_____________________________________________
I have no money in bank accounts, savings & loans, credit unions, money market or mutual funds
I have the following accounts:
Checking Account at _____________________________________________ with a balance of $ ________________
Savings Account at ______________________________________________ with a balance of $ ________________
Money Market at ________________________________________________ with a balance of $ ________________
Certificate of Deposit at ___________________________________________ with a balance of $ ________________
Safe Deposit Box at _____________________________________________ containing _______________________
I do not own any real estate.
I own property at ________________________________________________ with ____________________________
I have a beneficial interest in a land trust. The name and address of the trustee are:
_________________________________________________________________________________________________
The beneficial interest is listed in my name and ________________________________________________________
There is a mortgage on my property. The mortgage company’s name and address are:
_________________________________________________________________________________________________
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171-351 (Rev. 08/12)
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An assignment of beneficial interest in the land trust was signed to secure a loan from:
_________________________________________________________________________________________________
I own: ___ car(s): (make and model) _____________________________ VIN: ____________________________
Lien holder: ___________________________________________________________________
(make and model) _____________________________ VIN: ____________________________
Lien holder: ___________________________________________________________________
(make and model) _____________________________ VIN: ____________________________
Lien holder: ___________________________________________________________________
Jewelry: (description) _____________________________________________________________________________
_________________________________________________________________________________________________
Stocks/Bonds (name/institution and value) _____________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Income Tax Returns presented for tax years: _____________________________________________________________
Any asset/property not noted above valued over $500.00: ___________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Money people owe debtor:
From Whom:_________________________________________ Amount:$ _____________________________________
From Whom:_________________________________________ Amount:$ _____________________________________
From Whom:_________________________________________ Amount:$ _____________________________________
From Whom:_________________________________________ Amount:$ _____________________________________
Debtor’s Signature(s) _________________________________ _____________________________________________
_________________________________ _____________________________________________
Print Name
Print Name
Dated: ________________________ 20 ____
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171-351 (Rev. 08/12)
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