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Notice Of Confidential Information Within Court Filing 171-403 - Illinois
| Notice Of Confidential Information Within Court Filing Form. This is a Illinois form and can be used in General Lake Local County . |
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IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS ) ) ) ) Plaintiff/Petitioner, ) ) ) ) ) ) Defendant/Respondent. ) v. Case No. NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING Pursuant to Illinois Supreme Court Rule 15, the filer of a court record at the time of filing shall include a confidential information form which identifies the full social security numbers for any individuals whose social security numbers are redacted within the filing. This information will not be available to the public and this document will be stored in a separate location from the case file. Party/Individual Information: 1. Name: ____________________________________ 2. Name: ______________________________________ Address: ____________________________________ Address: ______________________________________ ____________________________________ Phone: SSN: ____________________________________ ____________________________________ Phone: SSN: ______________________________________ ______________________________________ ______________________________________ 3. Name: ____________________________________ 4. Name: ______________________________________ Address: ____________________________________ Address: ______________________________________ ____________________________________ Phone: SSN: ____________________________________ ____________________________________ Phone: SSN: ______________________________________ ______________________________________ ______________________________________ (Attach additional pages, if necessary.) Prepared by: Attorney's Name: ____________________________________ Address: __________________________________________ City: ______________________________ State: __________ Phone: ______________________Zip Code: _____________ Fax: ______________________________________________ ARDC: ____________________________________________ Form 171-403 (Rev. 8/12) American LegalNet, Inc. www.FormsWorkFlow.com
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