Free CCL 0092 3-29-07.pmd - Illinois

Summons in Administrative Review IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - LAW DIVISION

(Rev. 3/29/07) CCL 0092

__________________________________________________
PLAINTIFF

v. ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, an administrative agency of the State of Illinois; DIRECTOR OF THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY; BOARD OF REVIEW, an administrative agency of the State of Illinois; and

No. ______________________________

_________________________________________, employer
DEFENDANTS

SUMMONS IN ADMINISTRATIVE REVIEW
To each defendant: YOU ARE SUMMONED and required to file an answer in this case or otherwise file your appearance in the office of the clerk of this court located in Room 801, Richard J. Daley Center, 50 W. Washington, Chicago, Illinois within 35 days after the date of this summmons. WITNESS _________________________, _______

_____________________________________________
Name: Address:

__________________________________________ __________________________________________

City/State/Zip: __________________________________________ Telephone:

__________________________________________
CERTIFICATE OF MAILING

On _________________________________, __________ I sent by registered mail a copy of this summons to each defendant addressed as follows: DEFENDANT Board of Review Director of the Illinois DEPARTMENT OF EMPLOYMENT SECURITY ADDRESS 33 S. State Street, 9th Floor Chicago, Illinois 60603 33 S. State Street, 9th Floor Chicago, Illinois 60603

________________________________________________
(Employer)

________________________________________ _____________________________________
Dated ____________________________, ________

______________________________________
Clerk of Court DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS