IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS Plaintiff vs CASE NO: Defendant NOTICE OF REJECTION OF AWARD To the Clerk of the Circuit Court: Notice is given that rejects the award of the arbitrators entered in this cause on and requests a trial before the Court. I further more certify that I have paid the filing fee of: (please mark the appropriate box) , 20 , $200.00 (For Awards =< $30,000.00) $500.00 (For Awards > $30,000.00) Fees are waived (Must include Rule 298 poor person waiver form) ( Signature) PROOF OF SERVICE On on oath state that: , 20 I, , I served this notice by delivering a copy personally to all parties of record. I served this notice by mailing a copy to all parties of record and depositing the same in the U.S. Mail at , Illinois, with the proper postage prepaid. (Signature) Name ARDC # Firm Name Attorney for Address City & Zip Telephone ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY Orig. ­ Court Copy ­ Plaintiff Copy ­ Defendant American LegalNet, Inc. www.FormsWorkFlow.com AR 9 Revised (12/16)