Family Certificate Of Compliance Pursuant To Local Rule 11.02 Form - Lake County, Illinois
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1IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
RE: IN THE MARRIAGE OF
_____________________________________________ )
)
vs.
)
Case No. ________________________
)
)
_____________________________________________ )
FAMILY CERTIFICATE OF COMPLIANCE
PURSUANT TO LOCAL RULE 11.02
TO:
The undersigned hereby certifies that the FINANCIAL DISCLOSURE STATEMENT required by Local Court Rule
11.02(A)(3) has been completed, and was served upon the opposing party on the _____ day of _____________ , 20 ___ ,
with all CORROBORATING DOCUMENTS labeled and indexed to correspond to the appropriate paragraphs.
PROOF OF SERVICE
The undersigned on oath states that on _____________________ , 20 ____ :
I served this Family Certificate of Compliance by delivering a copy personally to each person to whom it is
directed.
I served this Family Certificate of Compliance by mailing a copy to each person to whom it is directed and
depositing the same in the U.S. Mail at ___________________, Illinois with the proper postage prepaid.
I served this Certificate of Compliance via facsimile.
CERTIFICATION
Under penalties provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that
the statements set forth in this instrument are true and correct, except as to matter therein stated to be on information and
belief and as to such matters the undersigned certifies as aforesaid that s/he verily believes the same to be true.
Date: _________________
________________________________________
Signature
Prepared by:
Name: ____________________________________________
Address: __________________________________________
City: ______________________________ State: __________
Phone: ______________________Zip Code: _____________
Fax: ______________________________________________
ARDC: ____________________________________________
171-440 (Rev 02/13)
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