IN THE CIRCUIT COURT OF THE TENTH JUDICIAL CIRCUIT OF ILLINOIS PEORIA COUNTY PLAINTIFF(S) vs. CASE NUMBER: AMOUNT CLAIMED: DEFENDANT(S)) SUMMONS TO EACH DEFENDANT: You are hereby summoned and required to appear before this Court in the Courthouse, Peoria,IllinoisinRoom-,d|-a.m.lp.m.o'clockon- to answer the complaint in this case, a copy of which is hereto attached. You are required to file your written appearance by yourself or your attorney and pay the required fee. Such a fee may be waived if a defendant is deemed a pauper by the Court. Pauper's affidavits are available and fees may be paid in the Office of the Circuit Clerk , Room G-22, Peoria County Courthouse, Peoria, Illinois. IF YOU FAIL TO DO SO, A JUDGMENT 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 fees, if any, immediately after service, and not less than 3 days before the day for appearance. If service cannot be made, this summons shall be returned so endorsed. This summons may not be served later than 3 days before the day ofappearance. ATTN DEFENDANT: HERE WILL BE A FEE TO FILE FOR YOUR APPEARANCE. WITNESS 20 CLERK OF COURT BY: DEPUTY ATTORNEY ADDRESS CITY TELEPHONE TIME AND DATE SUMMONS FORM # 336 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF ILLINOIS Sheriff s fees: Mileage Service COUNTY OF PEORIA Return_ Total SERVICE I ce.rtifu that I served this summons on defendant as follows: (Check appropriate box, and complete information below.) L-l E (a) (b) (individual defendants - personal) By leaving a copy and a copy of the complaint with each individual defendant personally.!! (individual defendants- personal) 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 of 13 years or upwards, informing that person of the contents and also sending a copy of the summons in a sealed envelope with postage fully prepaid, addressed to each individual defendant at his usual place ofabode. (Corporation defendants) By leaving a copy of the complaint with the registered agent , officer or agent of each defendant corporation. E E (c) (d) (other service) E Name of Defendant Name of Persons Summons given To Defendant not found in my County Date of Service Time Sex_Race_Approximate Place of Service Age_Date Notes, Other of mailing_ Sheriff, by: CERTIFIED MAIL Deputy STATE OF ILLINOIS COUNTY OF PEORIA I, Robert M. Spears, Clerk of said Court, in the County and State aforesaid, hereby certiff the U.S. Post Office, Peoria in the County and State aforesaid, I that on_,20_at by United States certified mail, retum receipt requested, which receipt is hereto sent attached ,a copy of this Summons, together with a copy of the complaint, in a sealed envelope with postage fully prepaid, addressed to Defendant at last known mailing address. Robert M. Spears, Circuit Clerk, By: American LegalNet, Inc. www.FormsWorkFlow.com