IN THE CIRCUIT COURT OF THE 20th JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS CERTIFICATION OF JUDGMENT BALANCE Employer Name:________________________________ Address:______________________________________ City, State, Zip:_________________________________ RE: Creditor:______________________________________ Defendant:____________________________________ Case No.:_____________________________________ Balance Due at End of Last Quarter: $___________________________ Pursuant to the Illinois Code of Civil Procedure, Section 12/808.5 the undersigned hereby certifies that the above stated amount is the balance due on the judgment as of the last day of the last calendar quarter. Please note that the law requires the employer to hand deliver or mail by First Class Mail, a copy of this certification to the judgment debtor at the judgment debtor's last known address. _______________________________ Attorney for Judgment Creditor or Pro Se Creditor American LegalNet, Inc. www.FormsWorkflow.com