Summons In Administrative Review (Workers Comp Only) {42B}

IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS Plaintiff vs CASE NO. Defendants SUMMONS IN ADMINISTRATIVE REVIEW (Except Worker222s Compensation) To each defendant: You are hereby summoned and required to file an answer in this case or otherwise file your appearance in the Office of the Clerk of this Court within thirty-five (35) days after service of this summons. E-filing is now mandatory for documents in civil cases with limited exemptions. To e-file, you must first create an account with an e-filing service provider. Visit http://efile.illinoiscourts.gov/service-providers.htm to learn more and to select a service provider. If you need additional help or have trouble e-filing, visit http://www.illinoiscourts.gov/FAQ/gethelp.asp , or talk with your local circuit clerk222s office. This summons is served upon you by certified mail pursuant to the provisions of the Administrative Review Law. WITNESS, 20 (Seal of Court) (Clerk of the Circuit Court) Certificate of Mailing On , 20, a copy of this summons was sent to each defendant222s address by CERTIFIED MAIL DELIVERY as follows: DEFENDANT ADDRESS ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY 42A (Part 1 of 2) Revised (02/19) American LegalNet, Inc. www.FormsWorkFlow.com DEFENDANT ADDRESS 20 (Date) (Clerk of the Circuit Court) Attorney or Party, if not represented by an attorney Name ARDC # Firm Name Attorney for Address City & Zip Telephone E-Mail (If service by facsimile transmission will be accepted, the telephone number of the plaintiff or plaintiff222s Attorney222s facsimile machine is additionally required.) ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY 42A (Part 2 of 2) Revised (02/19) American LegalNet, Inc. www.FormsWorkFlow.com