State of Illinois Sangamon County } Affidavit of Service When served by a person, not an officer _______________________________________being duly sworn, on oath deposes and says that on the _____ Day of ______________________, ______ he/she served the within Notice by delivering a copy thereof to the within named:____________________________________. By leaving the same with _________________________________ a person above the age of twelve years, residing on, or being in charge of the premises. By posting the same on the premise, no person being in actual possession thereof. Note: Check one (1) of the above boxes in accordance with the facts of service. Signature Subscribed and sworn to before me Date Notary Public Served the within Notice by delivering a copy thereof to: this _____ day of _____________________, 20______ IN THE CIRCUIT COURT (CIVIL DIVISION) CASE NO:_____________________ STATE OF ILLINOIS COUNTY SANGAMON Fees - Mileage....... $___________ Service........ $___________ TOTAL....... $___________ FIVE DAY NOTICE Defendant(s) Defendant(s) Defendant(s) Petitioner(s) Petitioner(s) Petitioner(s) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Sheriff VS. In The Circuit Court For The Seventh Judicial Circuit of Illinois Sangamon County, Springfield, Illinois Case Number: LANDLORD'S FIVE DAY NOTICE TO: YOU ARE HEREBY NOTIFIED, that there is now due dollars and cents, being rent for the premises situated in of No. the sum of and known and described as follows, viz.: The Street, otherwise described as . , FURTHER, YOU ARE HEREBY NOTIFIED that only FULL PAYMENT of the rent demanded in this Notice will waive the landlord's right to terminate the lease under this Notice, unless the landlord agrees in writing to continue the lease in exchange for receiving partial payment. IN ADDITION, YOU ARE FURTHER NOTIFIED that payment of said sum so due, has been and is hereby demanded of you, and unless payment thereof is made on or before five days after service of this Notice upon you, your Lease of said premises will be terminated. at No. , Street, is hereby authorized to receive said rent, so due, for . Date Landlord Agent Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com