Complaint Form - Circuit Court Of Illinois
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1CIRCUIT COURT OF ILLINOIS
CIRCUIT COURT OF ILLINOIS
Sixth Judicial Circuit
Sixth Judicial Circuit
Champaign County
CIRCUIT COURT OF ILLINOIS
CIRCUIT COURT OF ILLINOIS
Champaign County
Sixth Judicial Circuit
Sixth Judicial Circuit
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Champaign County
Champaign County
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Petitioner(s)
Peti-
_______________________________
_______________________________
tione
r(s)
CIRCUIT COURT OF ILLINOIS
vs.
Case No:_________________
_______________________________
_______________________________
vs.
_______________________________
_______________________________
Petitioner(s)
Petitioner(s)
Peti-
Peti-
Sixth Judicial Circuit
tione
_______________________________
tione
_______________________________
r(s)
r(s)
vs.
vs.
Case
Case No:_________________
Champaign County
vs.
vs.
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Respondent(s)
_______________________________
_______________________________
Respondent(s)
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Petitioner(s)
Respondent(s)
Respondent(s)
Peti-
Respondent(s)
Respondent(s)
tione
r(s)
vs.
Case
COmPLaINT
vs.
_______________________________
_______________________________
I, the undersigned, claim that the Respondent is indebted to the Petitioner in the sum of
COmPLaINT
COmPLaINT
_______________________________
_______________________________
$_______________for_______________________________________________________________________
I, the undersigned, claim that the Respondent is indebted to the Petitioner
I, the undersigned, claim that the Respondent is indebted to the Petitioner in the sum of
_______________________________
_______________________________
__________________________________________________________________________________________
Respondent(s)
Respondent(s)
$_______________for_______________________________________________________________________
$_______________for__________________________________________________
__________________________________________________________________________________________
_____________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
_____________________________________________________________________
__________________________________________________________________________________________
COmPLaINT
and that Petitioner has demanded payment of said sum; that the Respondent refused to pay the
__________________________________________________________________________________________
_____________________________________________________________________
same and no part thereof has been paid; that the Respondent resides at _______________________
I, the undersigned, claim that the Respondent is indebted to the Petitioner
and that Petitioner has demanded payment of said sum; that the Responde
and that Petitioner has demanded payment of said sum; that the Respondent refused to pay the
____________________________________________________, Phone No:__________________________;
$_______________for__________________________________________________
same and no part thereof has been paid; that the Respondent resides at _______________________
same and no part thereof has been paid; that the Respondent resides at __
that Petitioner resides at__________________________________________________________________
_____________________________________________________________________
____________________________________________________, Phone No:______
____________________________________________________, Phone No:__________________________;
_______________________________________, Phone No:__________________________________ in the
_____________________________________________________________________
that Petitioner resides at_____________________________________________
that Petitioner resides at__________________________________________________________________
State of Illinois.
_____________________________________________________________________
_______________________________________, Phone No:__________________________________ in the
_______________________________________, Phone No:___________________
and that Petitioner has demanded payment of said sum; that the Responde
Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil
State of Illinois.
State of Illinois.
same and no part thereof has been paid; that the Respondent resides at __
Procedure (Perjury-Class 3 Felony), the undersigned certifies that the statements set
forth in this Complaint are true and correct.
Under the penalties as provided by law pursuant to Section 1-109 o
Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil
____________________________________________________, Phone No:______
Procedure (Perjury-Class 3 Felony), the undersigned certifies that
Procedure (Perjury-Class 3 Felony), the undersigned certifies that the statements set
that Petitioner resides at_____________________________________________
forth in this Complaint are true and correct.
forth in this Complaint are true and correct.
_______________________________________, Phone No:___________________
________________________________________________
(Signature of Petitioner)
State of Illinois.
________________________________________________
________________________________________________
(Signature of Petitioner)
(Signature of Petitioner)
Under the penalties as provided by law pursuant to Section 1-109 o
Date:___________________________________________
Procedure (Perjury-Class 3 Felony), the undersigned certifies that
forth in this Complaint are true and correct.
Revised: 2/09
Linda S. Frank
Date:___________________________________________
Date:___________________________________________
Revised: 11/03; 2/09; 6/10
SP 2/24/09
Linda S. Frank
Clerk of the Sixth Judicial Circuit Court
Katie M. Blakeman
Clerk of the Sixth Judicial Circuit Court
101 E. Main Street
Revised: 2/09
Revised: 2/09
Linda S. Frank
Linda S. Frank
Urbana, Illinois 61801
101 E. Main Street
SP 2/24/09
Clerk of the Sixth Judicial Circuit Court
Clerk of the Sixth Judicial Circuit Court
________________________________________________
Urbana, Illinois 61801
101 E. Main Street
101 E. Main Street
(Signature of Petitioner)
Urbana, Illinois 61801
Urbana, Illinois 61801
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