Uniform Order For Support Form - Lake County, Illinois Page 4
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4Case No. _______________________
Other:
The “Child Support Data Sheet” attached hereto, as Exhibit 1, is a part of this Order.
It is ordered the Clerk of the Court impound Exhibit 1 until further order of this Court.
FAILURE TO OBEY ANY OF THE PROVISIONS OF THIS ORDER MAY RESULT IN A FINDING OF CONTEMPT OF
COURT
Dated at Waukegan, Illinois this
Enter:
day of
, 20
JUDGE
Prepared by:
Name: ____________________________________________
Attorney's Name: ___________________________________
Address: __________________________________________
City: ______________________________ State: __________
Phone: ______________________Zip Code: _____________
Fax: ______________________________________________
ARDC #: __________________________________________
Form approved by Conference of Chief Circuit Judges
Page 4 of 4
171-195 (Rev. 06/13)
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