Free CCM N008 1-28-04 - Illinois

Complaint-Verified

(This form replaces CCMD-8A)

CCM N008-50M-2/25/05(

)

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

PRINT NAME OF PERSON OR PARTY SUING _______________________________________________
Plaintiff(s)

v.

PRINT NAME OF PERSON OR PARTY BEING SUED _______________________________________________
Defendant(s)

The Plaintiff(s) claim(s) as follows:

IF NO ATTORNEY, LEAVE BLANK PRINT NAME OF PERSON OR PARTY SUING I, _______________________________________, certify that I am the ________________________________________
(Name) (Name of Attorney if applicable)

E L P M A S
COMPLAINT THE PERSON OR PARTY SUING MUST PROVIDE THE REASON(S) WHY HE OR SHE WANTS TO FILE A COMPLAINT AGAINST THE PERSON OR PARTY BEING SUED.
Pro Se 99500 Signature DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
ORIGINAL COURT FILE

}

PRINT YOUR CASE NUMBER No. _____________________________________
Contract _________________________________ PRINT AMOUNT PLUS COURT COSTS Amount Claimed $ _________________________

PRINT RETURN DATE Return Date ______________________________

CLERK WILL ASSIGN A RETURN DATE

plaintiff in the above entitled action. The allegations in this complaint are true. Atty. No.: ______________ Atty. (or Pro Se Plaintiff):

PRINT TODAY'S DATE Dated:____________________________, ________ PLEASE SIGN YOUR NAME _______________________________________
Under penalties as provided by law pursuant to 735 ILCS 5/1-109 the abovesigned certifies that the statements set forth herein are true and correct.

PRINT YOUR NAME Name: __________________________________________ PRINT YOUR ADDRESS Address: ________________________________________ PRINT YOUR CITY, STATE AND ZIP CODE City/State/Zip: ___________________________________ PRINT YOUR COMPLETE TELEPHONE NUMBER Telephone: ______________________________________