Save As Print Clear IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS CASE NO _______________________________________ Plaintiff: _______________________________ _______________________________________ vs Defendant: _____________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ SMALL CLAIM COMPLAINT I, the undersigned, claim that the defendant is indebted to the plaintiff in the sum of $________________ for ______________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ and that plaintiff had demanded payment of said sum; that the defendant refused to pay the same and no part thereof has been paid; that the defendant resides at ________________________________________________ phone number _________________________________ that the plaintiff resides at ______________________ (Optional) ___________________________________________ phone number _________________________________ (Optional) in the State of Illinois. ____________________________________________________ (Signature of Plaintiff) Name _____________________________________ Address ___________________________________ City & Zip _________________________________ Telephone _________________________________ Attorney ___________________________________ ARDC # ___________________________________ Firm Name _________________________________ Attorney for ________________________________ Address ___________________________________ City & Zip _________________________________ Telephone _________________________________ ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY Original ­ Court Copy ­ Plaintiff Copy ­ Defendant American LegalNet, Inc. www.FormsWorkFlow.com 19A Revised (12/01/2016)