Distress Warrant - page 1 of 2 UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF McHENRY IN THE CIRCUIT COURT OF THE TWENTY-SECOND JUDICIAL CIRCUIT Case Number: Amount Claimed $ Plaintiff Return Date: vs. Time: Address: 2200 N. Seminary Ave., Woodstock, IL 60098 Defendant Courtroom: DISTRESS WARRANT You are hereby authorized to distrain the goods and chattels of ______________________________________ which are liable to be distrained, wherever they may be found in the County of __________________________ where the said ___________________________ resides, for the sum of $_______________________________ Dollars, being the amount due me on the __________ day of ___________________________, A.D. 20 ___, for the rent of the following described premises, in said County:__________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ and for so doing, this shall be your sufficient warrant. Given under my hand and seal, this _________ day of ______________________________, A.D. 20______. (SEAL) Landlord To the above-named tenant ____________________________________________________________________ You are hereby notified that if you desire to claim your exemption under the statute relating to exemptions you must make and deliver to me a schedule of all your personal property within ten days from the service you. On this____________ day of ____________________________________ A.D. 20________, I delivered to ________________________________________________________________________ a copy of a Distress Warrant, and also a notice signed by me, of which the foregoing are true copies, and at the same time informed _______________________________________ of the contents thereof. CV-WAR1 revised 12/01/06 American LegalNet, Inc. www.FormsWorkflow.com Distress Warrant - page 2 of 2 INVENTORY OF PROPERTY LEVIED UPON Copy must be filed with: McHenry County Clerk of the Circuit Court 2200 N. Seminary Avenue Woodstock, IL 60098 CV-WAR1 revised 12/01/06 American LegalNet, Inc. www.FormsWorkflow.com