Illinois > Local County > Cook > Civil
Circuit Court Pre-Trial Memorandum CCM-0071 - Illinois
| Circuit Court Pre-Trial Memorandum Form. This is a Illinois form and can be used in Civil Cook Local County . |
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(This form replaces form CCM1-17) (Rev. 2/28/01) CCM 0071 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS MUNICIPAL DISTRICT __________ DISTRICT CIRCUIT COURT PRE-TRIAL MEMORANDUM (The information required in this memo should be full, complete, typewritten and in triplicate before case is called for hearing.) ___________________________________________________ ___________________________________________________ General Number ______________________________________ Plaintiff's Name: } Plaintiff requests ____________ $ ______________ Defendant recommends ______ $ ______________ Court recommends __________ $ ______________ Settlement figure ______ Age: $ ______________ ___________________________________________________ Occupation: ___________________________________________ Married or single: ___________________________________________________ Attorney for plaintiff: ___________________________________________ Attorney for defendant: ___________________________________________ Injuries: ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ Medical fee(s): ___________________________________________ ___________________________________________ ___________________________________________ Hospital bill(s): ___________________________________________ Loss of Income(s): ___________________________________________ ___________________________________________________ Date, hour and place of accident: ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ Attending physicians: ___________________________________________________ ___________________________________________________ ___________________________________________________ Name of hospital: ___________________________________________________ Place of employment: ___________________________________________________ Miscellaneous out-of-pocket: ___________________________________________________ ___________________________________________ Total liquidated damages: ________________________________________________________________________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Print This Form For your protection and privacy, please press the Clear This Form button after you have printed the form. Clear This Form
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