Free CCM 0141 4-07-09.pmd - Illinois

Summons in Administrative Review IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS FIRST MUNICIPAL DISTRICT

(4/07/09) CCM 0141

__________________________________________________
Plaintiff(s) v. City of Chicago Department of Administrative Hearings and City of Chicago Department of _________________________, and
(Insert name of issuing department.)

No. _______________________________________

____________________________________________________
Administrative Agency Docket Number

____________________________________________________
Property Address, if applicable Court Room: 1111 Court time: 10:30 a.m. - Non Parking Appeals 2:00 p.m. - Parking and Non Parking Appeals

__________________________________________________, and __________________________________________________
(Insert names of other parties)

Defendant(s)

SUMMONS IN ADMINISTRATIVE REVIEW
To Each Defendant: YOU ARE HEREBY SUMMONED AND REQUIRED to file an answer in this case or otherwise file your appearance within 35 days after the date of this summons, in the Office of the Clerk of the Circuit Court located in Room 602, Richard J. Daley Center, Chicago, Illinois 60602. This summons is served upon you by registered or certified mail pursuant to the provisions of the Administrative Review Law. WITNESS _______________________________, __________ _______________________________________________ Clerk of Court (S E A L) Plaintiff Name: ____________________________________________________________________________________ Address: _________________________________________________________________________________________ Telephone (_________) _________________________ Facsimile Telephone (_________) _______________________

CERTIFICATE OF SERVICE
I, ________________________________________, certify under penalties as provided in 735 ILCS 1-109 that I served the following parties by registered or certified mail on ______________________________, __________

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Signature

________________________________ , __________
Date

SERVICE LIST
1. 2. 3. 4. City of Chicago, __________________________________, 30 N. LaSalle St., Suite 1640, Chicago, IL 60602
(Insert name of issuing department)

City of Chicago Department of Administrative Hearings, 740 N. Sedgwick, 6th Fl., Chicago, IL 60610 City of Chicago Law Department, 30 N. LaSalle St, Suite 1640, Chicago, IL 60602 Other: ________________________________________________________________________________________

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