STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE FOURTEENTH JUDICIAL CIRCUIT ROCK ISLAND COUNTY (Name all parties) No. _______________________ Plaintiff Vs. Amount claimed $_______________________ Defendant SUMMONS To each defendant: YOU ARE HEREBY SUMMONED and required to appear before this Court at SMALL CLAIMS DIVISION, ROCK ISLAND COUNTY COURTHOUSE, ROCK ISLAND, ILLINOIS, Room 103 at _______________________________.M. on_______________________________20__________to answer the complaint in this case, a copy of which is hereto attached. IF YOU FAIL TO DO SO, A JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR 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 and 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 of appearance. WITNESS____________________, 20_______ __________________________________ (Clerk of the Circuit Court) (Seal of Court) ___________________________________________________ (Deputy) (Plaintiff's attorney or plaintiff if he is not represented by an attorney) Name____________________________________ Attorney for________________________________ Address___________________________________ City______________________________________ Telephone_________________________________ Small claims summons 4/16 American LegalNet, Inc. www.FormsWorkFlow.com SHERIFF'S FEES Service and/or Return......................................... $_________________ Mileage......................................................... $_________________ Total............................................................ $_________________ I certify that I served this Summons on defendants as follows: (Check appropriate box, and complete information below) (a) (b) - (Individual defendants-personal): By leaving a copy and a copy of the complaint with each individual defendants personally. - (Individual defendants-abode): 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 by sending a copy of the Summons in a sealed envelope with postage fully prepaid, addressed to each individual defendant at his usual place of abode. - (Corporation defendants): By leaving a copy and a copy of the complaint with the registered agent, officer or agent of each defendant corporation. (c) (d) - (Other service): Name of Defendant _______________________________ Name of Defendant________________________ _______ Name of Person Name of Person Summons given to_________________________________Summons given to________________________________ Sex_______________Race________Approx. Age_______ Sex______________Race________Approx. Age _______ Place of Service__________________________________ Place of Service__________________________________ _______________________________________________ _______________________________________________ Date of Service________________Time______________ Date of Service__________________Time____________ Date of Mailing__________________________________ Date of Mailing__________________________________ By______________________________________, Deputy By______________________________________, Deputy (e) -(Not found): The within named __________________________________________not found in this County this______________day of _____________________, 20__________. REASON: _____________ __________________________________, By__________________________________, Deputy ___________________________________Sheriff of ______________________________County Small claims summons 4/16 American LegalNet, Inc. www.FormsWorkFlow.com