2118 2119
Summons Served by Special Process Server Summons Not Served by Special Process Server (8/19/08) CCCH 0061
Affidavit of Special Process Server IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
____________________________________________ DEPARTMENT, ______________________________________ (County) (Municipal) (Division) (District)
CASE NO. ________________________________
AFFIDAVIT OF SPECIAL PROCESS SERVER __________________________________________________________ being first duly sworn on oath deposes and states that s/he was appointed by the Court on ___________________________, __________ to serve process in the above mentioned cause. The following individuals were SERVED / NOT SERVED with summons and a copy of the complaint: Named Defendant (S) Served / (N) Not Served (S) ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ 2118 2118 2118 2118 2118 2118 2118 2118 2118 (N) 2119 2119 2119 2119 2119 2119 2119 2119 2119 Substitute Service Date of Service
(of the age of 13 or upwards) ________________________________________________________________________________________
_____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________
_____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________
Date: ________________________________, __________
________________________________________________ Special Process Server Signature
Signed and sworn before me on this __________________ day of _____________________________________, __________ __________________________________ Notary public
DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS