STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE FOURTEENTH JUCICIAL CIRCUIT ROCK ISLAND COUNTY VS. NO.______________ APPEARANCE AND CONSENT I appear in this case as defendant and consent to the entry of an immediate default and to a hearing without further notice. ________________________ Name______________________________ Address____________________________ City________________________________ Telephone___________________________ Subscribed and sworn to before me, a Notary Public, this ____day of ____________,20____. ________________________________ Notary Public 8/07 American LegalNet, Inc. www.FormsWorkflow.com