Entry Of Appearance - Illinois

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State Of Illinois, Department Of Labor
160 North Lasalle Street, Suite C-1300
Chicago, Illinois 60601
DOL.Hearings@illinois.gov
Entry Of Appearance
Case Number _____________
I, ____________________________________________________, an attorney, hereby enter my appearance
on behalf of_________________________________________________ in the above referenced case. I further agree to accept
service of all documents on behalf of ____________________________________________________ in this matter.
Name
____________________________________________________
Firm Name
____________________________________________________
Firm Address
____________________________________________________
____________________________________________________
____________________________________________________
Phone Number
____________________________________________________
Email Address
____________________________________________________
I agree to accept service of all documents in this matter by electronic mail at the e-mail address set forth above. By accepting and
submitting this form, I affirm and certify that all information provided and the statements made herein are true, correct, and complete.
Signature
____________________________________________________
Date
____________________________________________________
ILLINOIS DEPARTMENT OF LABOR

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