DV-LC 116. Page 1 of 1 (0/1) LETTER TO THE CIRCUIT CLERK ( FILING FORMS TO START A NEW CASE ) Instructions to User 1. 2. 3. Date: Circuit Clerk of County Address of Circuit Clerk Dear Clerk : Re: v. Case Number: Plaintiff/Petitioner Defendant/Respondent I am enclosing the Summons and Certificate of Dissolution, and the original and one copy of the Petition for Dissolution of Marriage/Civil Union to be filed. Check the box that appl ies : I have enclosed an Application for Waiver of Court Fees and an Order for Waiver of Court Fees . Please present these to a Judge ; OR I have enclosed the cost of filing these documents $ . Please issue the Summons and file the documents and return the Summons and file - stamped copies to me in the enclosed self - addressed and stamped envelope. Thank you for your attention to this matter. Sincerely, Signature Printed Name Street Address , Apt # City State Zip Phone American LegalNet, Inc. www.FormsWorkFlow.com