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Summons To Respondent Workers Compensation Review CCL-0037 - Illinois
| Summons To Respondent Workers Compensation Review Form. This is a Illinois form and can be used in Law Cook Local County . |
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2145 - Served 2245 - Not Served (Rev. 11/01/04) CCL 0037 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION __________________________________________________ v. No. _____________________________ Illinois Workers Compensation Commission of Illinois and } __________________________________________________ SUMMONS TO RESPONDENT WORKERS COMPENSATION REVIEW To _______________________________________________________________________, respondent, and ________________________________________________________________________ ___, attorney for respondent. YOU ARE SUMMONED and required to file your appearance in this case in th e office of the clerk of this court located in Room 801, Richard J. Daley Center, Chicago, Illinois, on or b efore* _______________________________ ___________________________________, ________ and show cause why the dec ision or award of the Illinois Workers Compensation Commission of Illinois rendered on ______________________________, ________, for ________________________________________________________________________ ____________ against ________________________________________________________________________ ______________ should not be reversed. IFYOU FAIL TO DO SO, THE DECISION OR AWARD MAY BE REVERSED. Atty. No.:__________________ WITNESS ________________________, ________ Name: ____________________________________________ ________________________________________ Atty. for: __________________________________________ DOROTHY BROWN, Clerk of the Circuit Court Address: __________________________________________ City/State/Zip: _____________________________________Date of service ________________________, ________ (To be inserted by officer on copy left with employerTelephone: _______________________________________ or other person) *10 to 60 days from date of issuance of this summons **Service by Facsimile Transmission will be accepted at: ______________________________________________ (Area Code) (Facsimile Telephone Number) DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS American LegalNet, Inc. www.USCourtForms.com
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