SUMMONS ILLINOIS DOMESTIC VIOLENCE ACT IN THE CIRCUIT COURT OF THE FOURTEENTH JUDICIAL CIRCUIT ROCK ISLAND COUNTY, ILLINOIS _________________________________ No._____________________ Petitioner Independent Petition Criminal Proceedings Dissolution V. ________________________________________ Respondent Address:______________________________ ______________________________ To each respondent: You are summoned and required to file an answer in this case, or otherwise file your appearance in the: Office of the Circuit Clerk COURTHOUSE Building 210-15th STREET ROCK ISLAND, Illinois within 7 days after service of this summons, not counting the day of service. IF YOU FAIL TO DO SO, A JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE RELIEF ASKED IN THE PETITION. To the officer: This summons must be returned by the office or person to whom it was given for service, with endorsement of service and fees, if any, immediately after service. If service cannot be made, summons shall be returned so endorsed. This summons may not be served later than 30 days after its date. WITNESS_____________________________, 20_________ (Seal of Court) _________________________________________ Clerk of the Circuit Court By:______________________________________ Deputy (Signature of Attorney or Signature of Petitioner, if not represented) Petitioner’s Name____________________________________ Address: ____________________________________ City: ____________________________________ Phone: ____________________________________ SUMMONS IL DOM.ACT Revised 07/2006 American LegalNet, Inc. www.FormsWorkflow.com SHERIFF’S FEES SERVICE AND/OR RETURN…………………………………………………………$_______________ MILEAGE……………………………………………………………………………….$_______________ TOTAL…………………………………………………………………………………..$_______________ I Certify that I served this Summons as directed as follows: (Check appropriate box, and complete information below) (a)-(Individual-personal): By leaving a certified copy of this Summons with each below-named individual personally. (b)-(Individual-abode) By leaving a certified copy of this Summons at the usual place of abode of each below-named Individual with a person of his family or a person residing there, of the age of 13 years or upward, informing that person of the contents and also by sending a copy of the Summons in a Sealed envelope with postage fully prepaid, addressed to each such individual at his usual Place of abode. Name of Person Summons given to________________________ Sex______Race______Approx Age__________ Place of Service__________________________ ________________________________________ Date of Service____________Time___________ Date of Mailing___________________________ By_________________________________Deputy Name of Person Summons given to_________________________ Sex______Race______Approx Age___________ Place of Service___________________________ ________________________________________ Date of Service__________Time_____________ Date of Mailing___________________________ By________________________________Deputy (c)-(Not found): The within named____________________________________________not found in this County this _______________day of ______________________________, 20__________, REASON:__________________________________________________________________________, By________________________________, Deputy_________________________________________ Sheriff of ________________________________________County. ORDER RETURN Sheriff’s return dom.wps American LegalNet, Inc. www.FormsWorkflow.com