Free CCG-0125 - Illinois

Pro Se Complaint For Illinois Administrative Review IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

(Rev. 6/11/02) CCG 0125

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Plaintiff vs No: ________________________________

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Defendant Village of _____________________________________________ Department of Administrative Hearings

____________________ Department

PRO SE COMPLAINT FOR ILLINOIS ADMINISTRATIVE REVIEW
Now comes the Plaintiff ________________________________________________________________ pursuant Village of __________________________________________________________________________ Defendant, 1. Plaintiff resides at ________________________________________________________________________________ 2. On _________________________________________________, a final administrative decision was rendered by the Village of ______________________________________________ affecting the rights of the Plaintiff. 3. The Plaintiff desires a judicial review of said decision, a copy of which is attached hereto as Exhibit 1, because said decision is not in accordance with the law. 4. The Village of ______________________________________________________ is hereby requested to file an answer consisting of the record of proceedings had before the said administrative agency. 5. The Plaintiff has exhausted all available administrative remedies under the Act and has no further plain, speedy, or adequate remedy in the ordinary course of law. WHEREFORE, the Plaintiff prays that said record be judicially reviewed. Name: ____________________________________________ Address: _______________________________________________ City/State/Zip: __________________________________________ Telephone: _____________________________________________

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Plaintiff-Pro Se

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS