Motion To Claim Exemption Under Wage Deduction Form - Circuit Court Of Illinois Page 2
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1
2CIRCUIT COURT OF ILLINOIS
Sixth Judicial Circuit
Champaign County
___________________________________
Petitioner
vs.
Case No:_________________
___________________________________
Respondent
NOTICE OF MOTION FOR WAGE DEDUCTION EXEMPTION HEARING
NOTICE OF MOTION FOR WAGE DEDUCTION OR CITATION EXEMPTION HEARING
TO: Petitioner or Attorney for Petitioner
Employer or Attorney for Employer
Name: ______________________________
Name:_________________________________
Address:_____________________________
Address:________________________________
City/State/Zip:________________________
City/State/Zip:___________________________
On ___________________, 20__ at ___________ a.m./p.m., or as soon after as cause may be heard,
I shall appear before Judge _______________________ in Courtroom ______ at the Champaign County
Courthouse at 101 East Main Street, Urbana, Illinois, or any Judge sitting in his/her stead and present a
Motion to Claim Exemption Under Wage Deduction or Citation Proceedings.
Name: _______________________________________
_______________________________
Address: _____________________________________
Respondent’s Signature
City/State/Zip:_________________________________
Telephone: ____________________________________
Date: __________________________
PROOF OF SERVICE
I, ____________________________________, on oath state that:
______ On ___________, 20___ I served this Notice by delivering a copy personally to the parties to
whom it was directed at ________ a.m./p.m.
______ On __________, 20___ I served this Notice by mailing a copy to the parties named above by
depositing same in the United States Mail at _____________________, Illinois at ________ a.m./p.m.
with first class postage prepaid.
Subscribed and sworn to before me on ___________________, 20___.
_______________________________
Circuit Clerk/Notary Public
Revised: 12/12
Katie M. Blakeman
Clerk of the Sixth Judicial Circuit Court
Clerk of the Sixth Judicial Circuit Court
101 E Main
Urbana, IL 61801
101 E. Main Street
Urbana, Illinois 61801
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