This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit courts. SC - N 3104.1 Page 1 of 2 ( 03 / 18 ) STATE OF ILLINOIS , NOTICE OF COURT DATE FOR EMERGENCY MOTION TO CLAIM EXEMPTION For Court Use Only CIRCUIT COURT COUNTY Instructions Directly above, enter the name of the county where the Citation to Discover Assets to Debtor's Bank was filed. Plaintiff ( First, middle, last name ) v. Fill in the rest of the information by copying it from the Citation. Defendant ( First, middle, last name ) Case Number Respondent (Bank222s n ame) In 1 a , enter the date and time of your court date. The Circuit Clerk will give you the date and time of the court date when you file your Emergency Motion to Claim Exemption. 1 . Court Date Information The reasons for this court date are listed in the attached Emergency Motion to Claim Exemption . The court date for the Emergency Motion to Claim Exemption I filed is scheduled for: a. Date: , 20 Time: a.m. p.m. In 1b , also enter the address of the court and courtroom number for the court date . b. Address: Street City State ZIP Courtr oom: Attach a copy of your Motion to this Notice. P ROOF OF DELIVERY 1. I sent the Emergency Motion to Claim Exemption and Notice of Court Date for Emergency In 1a, enter full name and address of other party or other party's lawyers you are sending a copy of the Motion to. You can find this information on the Citation to Discover Assets to Debtor's Bank. Motion to Claim Exemption. a. To the other party: Name: First Middle Last Address: Street , Apt # City State ZIP Email address: b. By: Personal hand delivery In 1b, check the box to show how you sent the document, and fill in any other information required on the blank lines. Regular, First - Class Mail, put into the U.S. Mail with postage paid at: Address of Post Office or Mailbox Third - party commercial carrier, with delivery paid for at: NOTE: There may be local rules about how many days before the court date you have to give notice to the other parties. Ask the Circuit Clerk where to find these rules. Look for rules about motions and notice of hearing. Name (for example, FedEx or UPS ) and office address The court's electronic filing manager (EFM) or an approved electronic filing service provider (EFSP) Email (not through an EFM or EFSP) Mail from a prison or jail at: Name of prison or jail c. On: In c, fill in the date and time that you sent the document. Date At: a.m. p.m. Time American LegalNet, Inc. www.FormsWorkFlow.com Enter the Case Number given by the Circuit Clerk: SC - N 3104.1 Page 2 of 2 ( 03 / 18 ) In 2a, enter the full name and address of the respondent/bank you are sending a copy of the Motion to. You can find this information on the Citation to Discover Assets to a Debtor's Bank. 2. I sent this document: a. To b ank: Name: First Middle Last Address: Street , Apt # City State ZIP Email address: In 2b, check the box to show how you sent the document, and fill in any other information required on the blank lines. b. By: Personal hand delivery Regular, First - Class Mail, put into the U.S. Mail with postage paid at: Address of Post Office or Mailbox Third - party commercial carrier, with delivery paid for at: CAUTION: You may only send this form by email if the other party has agreed to receive documents in the lawsuit by email. Name (for example, FedEx or UPS ) and office address The court's electronic filing manager (EFM) or an approved electronic filing service provider (EFSP) Email (not through an EFM or EFSP) Mail from a prison or jail at: Name of prison or jail Under the Code of Civil Procedure, 735 ILCS 5/1-109 , making a statement on this form that you know to be false is perjury, a Class 3 Felony. I certify that everything in the Proof of Delivery is true and correct. I understand that making a false statement on this form is perjury and has penalties provided by law under 735 ILCS 5/1 - 109 . /s/ Your Signature Street Address If you are completing this form on a computer, sign your name by typing it. If you are completing it by hand, sign and print your name. Print Your Name City, State, ZIP Telephone American LegalNet, Inc. www.FormsWorkFlow.com