file stamp here affidavit of damages

1
CANDICE ADAMS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 2348 (Rev.12/20) AFFIDAVIT OF DAMAGES Sworn and Subscribed before me File Stamp Here vs. AFFIDAVIT OF DAMAGES SUPREME COURT RULE 222 CASE NUMBER The undersigned being first duly sworn upon oath, deposes and states that he / she is a party to the above entitled cause of action seeking money damages or collection of taxes and states that this cause of action UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT does not exceed $50,000.00 does exceed $50,000.00 Date Date Notary Public / Circuit Court Clerk Name: DuPage Attorney Number: Attorney for: Address: City/State/Zip: Telephone Number: Pro Se Email: Signature

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Page 1: File Stamp Here AFFIDAVIT OF DAMAGES

CANDICE ADAMS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707

2348 (Rev.12/20)AFFIDAVIT OF DAMAGES

Sworn and Subscribed before me

File Stamp Here

vs.

AFFIDAVIT OF DAMAGES

SUPREME COURT RULE 222

CASE NUMBER

The undersigned being first duly sworn upon oath, deposes and states that he / she is a party to the above entitled cause of action seeking money damages or collection of taxes and states that this cause of action

UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT

does not exceed $50,000.00 does exceed $50,000.00

Date

Date

Notary Public / Circuit Court Clerk

Name:

DuPage Attorney Number:

Attorney for:

Address: City/State/Zip:

Telephone Number:

Pro Se

Email:

Signature