MADISON COUNTY SHERIFF'S OFFICE 405 Randle Street Edwardsville, IL 62025 To Whom It May Concern: The Madison County Sheriff's Department must have as much of the information requested below as possible. Respondent's Name: Respondent's Address: (Note: the Sheriff's Office cannot serve a post office box number) 1. 2. 3. Respondent's Physical Description: 4. Directions to address if a rural route box number: 5. Respondent's Employer's name and address: 6. Respondent is at work during the hours of: 7. Other possible location(s) for service on Respondent: 8. Any special instructions for service: 9. Respondent's Phone Number(s): 10. Petitioner's Phone Number(s): (Note: we must have a contact number to give you notification that the order was served.) 11. Date of Hearing: Your cooperation in this matter is greatly appreciated. Sincerely, Robert J. Hertz Sheriff of Madison County Revised: 09/18/2008 American LegalNet, Inc. www.FormsWorkflow.com