Landlord's Five Day Notice To: _________________________________________________________________________ You Are Hereby Notified, That there is now due the undersigned the sum of _____________________________ Dollars and ______________ Cents, being rent for the premises known and described as follow, to-wit: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ together with the lot or lots, wood sheds, garages, barns and other outbuildings thereto belonging, situated in the City of___________________ County of _____________ and State of Illinois. And You Are Further Notified, that payment of said sum so due, has been and is hereby demanded of you, unless payment thereof is made on or before the _________________ day of _______________________________ A.D. 20 ____, your Lease of said premises will be terminated. Only FULL PAYMENT of the rent demanded in this notice will waive the landlord's right to terminate the lease under this notice, unless the landlord agrees in writing to continue the lease in exchange for receiving partial payment. ____________________________________________________________ is hereby authorized to receive said rent so due me. Dated at _________________ this _____________ day of ________________ A.D. 20 _____. ______________________________Landlord By ____________________________Agent American LegalNet, Inc. www.FormsWorkFlow.com AFFIDAVIT OF SERVICE ­ When served by a person not an officer. STATE OF ILLINOIS County of Marion ss. _____________________________________________________________________being duly sworn, on oath deposes and that that on the _____ day of __________ A.D. 20 _____ he served the within notice: (a) By delivering a copy thereof to the within named ___________________________________________________ (b) By leaving a copy of the same with ____________________________________________________________________ (c) By posting a copy of same on the premises, no person being in actual possession thereof. SUBSCRIBED AND SWORN to before me this ______ day of ______________A.D. 20_____. ________________________________________ Notary Public ____________________________________________________________________ NOTE--Strike out (a), (b) or (c) in accordance with facts of service. American LegalNet, Inc. www.FormsWorkFlow.com Served the within notice by ________________________________________ ________________________________________ ________________________________________ _______ day of ___________ A.D. 20 _____. __________________________________________ ________________________________________ Service _______ Return______Mileage_______ THE CIRCUIT COURT OF THE 4TH JUDICIAL CIRCUIT Received a copy of the within notice this ____ day of _________________, 20____. __________________________________ __________________________________ No. ________________ MARION COUNTY, ILLINOIS FIVE DAY NOTICE Officer's Return Officer vs.