IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS _______________________________________ Plaintiff vs CASE NO: ______________________________ _______________________________________ Defendant SUPREME COURT RULE 222 ARBITRATION DISCLOSURES (Instructions: Complete this disclosure statement using all the information available to you at the time you are required to file this disclosure. Any effort to avoid disclosure of the information required to be disclosed in this statement is a serious violation of the Supreme Court Rule and could result in the trial court imposing sanctions provided for in Supreme Court Rules 219 and 222, including but not limited to dismissal of your action, entry of a default judgment against you, barring the testimony of any undisclosed witness or barring the introduction of other evidence which should have been disclosed but was not. You have a continuing duty to supplement, update and revise this disclosure statement whenever new or different information or documents become known. Your disclosure must include information and data in your possession, custody or control as well as that which can be ascertained, learned or acquired by reasonable inquiry and investigation. If additional space is needed, you may attach additional sheet(s)). 1. Identify and give the factual basis of the claim or defense. In the event of multiple claims or defenses, the factual basis for each claim or defense. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 2. Identify the legal theory upon which each claim or defense is based including, where necessary for a reasonable understanding of the claim or defense, citations of pertinent legal or case authorities. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 3. The names, addresses, and telephone numbers of any witnesses whom the disclosing party expects to call at trial with a designation of the subject matter about which each witness might be called to testify. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 4. The names, addresses, and telephone numbers of all persons whom the party believes may have knowledge or information relevant to the events, transactions, or occurrences that gave rise to the action, and the nature of the knowledge or information each such individual is believed to possess. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY Orig. ­ Court Copy ­ Plaintiff Copy ­ Defendant American LegalNet, Inc. www.FormsWorkFlow.com AR 2 Page 1 of 3 (Revised 12/16) 5. The names, addresses, and telephone numbers of all persons who have given statements, whether written or recorded, signed or unsigned, and the custodian of the copies of those statements. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 6. The names, addresses, and telephone numbers of each person whom the disclosing party expects to call as an opinion or expert witness at trial, plus the information called for by Rule 213 (f). _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 7. A computation of the measure of damages alleged by the disclosing party and the document or testimony on which such computation and measure are based and the names, addresses, and telephone numbers of all damage witnesses. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ a. Hospital, doctor and other medical bills; _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ b. Property damage; _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ c. Loss of income, salary and wages; _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ d. Other; ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 8. The existence, location, custodian and general description of any tangible evidence or documents that the disclosing party plans to use at trial and relevant insurance agreements. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 9. A list of the documents or, in the case of voluminous documentary information, a list of the categories of documents, known by a party to