Payment Order Form - Circuit Court Of Illinois
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1CIRCUIT COURT OF ILLINOIS
Sixth Judicial Circuit
Champaign County
__________________________
Petitioner(s)
vs.
Case No:________________
__________________________
R
espondent(s)
PAYMENT ORDER
YOU HAVE BEEN ORDERED AND DIRECTED TO MAKE:
installment payments in the sum of $ ______________________ commencing on the __________ day of
_____________, 20____, and a like amount ( ) weekly, ( ) biweekly or ( ) monthly thereafter until total
judgment and cost in the sum of $ ____________________ have been paid in full; said payments to be made to:
_________________________________________ at _____________________________________________,
Payee
Street Address
_________________________________________, Illinois _________________.
City
Zip
IT IS FURTHER ORDERED THAT:
1. The above Payment Order is binding on you until the full amount of the judgment has been paid, or until
otherwise ordered by the Court.
2. The payments must be made in the time, amount and place specified above.
3. If, for any reason, you are unable to make a payment, you must appear before the Judge giving this
Payment Order and request that the payments be temporarily stopped or reduced. Your request will then
be considered at a hearing which will be held at that time or shortly thereafter.
4. At the time of the hearing, you will be placed under oath and state the reasons why you cannot make the
payments as ordered. The Judge will then decide if the payments should be temporarily stopped or
reduced.
5. You must notify Petitioner’s Attorney or the Petitioner, in the event that he or she is not represented by
an Attorney, within 48 hours of any change of address and/or employment status.
6. If you do not make the payments as ordered without good cause being shown, and further fail to obtain
permission from the Judge to have the payments temporarily stopped or reduced, you may be held in
contempt of court which could result in a jail sentence.
Date: ___________________________, 20 ____ Entered: _____________________________________
Judge
I, the undersigned, approve the above and forgoing Payment Order as to form and acknowledge receipt of a
copy of such Order.
_________________________________________
Respondent’s Signature
_________________________________________
Street Address
_________________________________________
City/State/Zip Code
_________________________________________
Telephone
Revised: 11/99; 6/10
Katie M. Blakeman
Clerk of the Sixth Judicial Circuit Court
101 E. Main Street
Urbana, Illinois 61801
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