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Download and use this form in the State of Illinois for filing for divorce if you do not have any Minor Children.

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Text version of this Form

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How to file for divorce in Illinois — Supplement C

Divorce without minor children

This supplement includes a forms guide as well as forms. The forms guide is for use
only in filling out the forms. For more information about what these forms mean or are
used for, consult the appropriate Self Help packet.

8Board of Trustees, Southern Illinois University
May 2, 2003

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Forms that are included in this supplement:

Application to Sue As A Poor Person

Entry of Appearance, Waiver, and Consent

Entry of Appearance, Waiver, and Consent — Military

Certificate of Dissolution of Marriage (can only be obtained at courthouse)

Petition for Dissolution of Marriage — no children

Stipulation to Waiver of the Two Year Requirement

Notice of Hearing

Certificate of Mailing of Notice of Hearing

Judgment of Dissolution of Marriage — no children

Certificate of Mailing of Judgment of Dissolution of Marriage

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FORMS GUIDE

ALL FORMS:

At the top of each form is the “caption”. It is completed as follows:

STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE (number of circuit) JUDICIAL CIRCUIT

(name of county) COUNTY

IN RE THE MARRIAGE OF: )
)
(your name) )
)
Plaintiff, )
)
and ) No. (year) -D- (get from Clerk at the
) time you file)
(your spouse’s name) )
)
Defendant. )

Determine the number of the “Circuit” according to the chart on the next page. If your
county does not appear in the chart, call the Circuit Clerk in the county in which you will
be filing your case and ask for the number of the Circuit.

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Circuit Courts in Illinois

Cook County is its own judicial circuit. The rest of the counties in Illinois fall into one of
21 circuits.

First Circuit – The counties of Alexander, Pulaski, Massac, Pope, Johnson, Union, Jackson,
Williamson and Saline.

Second Circuit – The counties of Hardin, Gallatin, White, Hamilton, Franklin, Wabash, Edwards,
Wayne, Jefferson, Richland, Lawrence and Crawford.

Third Circuit – The counties of Madison and Bond.

Fourth Circuit – The counties of Clinton, Marion, Clay, Fayette, Effingham, Jasper, Montgomery,
Shelby and Christian.

Fifth Circuit – The counties of Vermilion, Edgar, Clark, Cumberland and Coles.

Sixth Circuit – The counties of Champaign, Douglas, Moultrie, Macon, DeWitt and Piatt.

Seventh Circuit – The counties of Sangamon, Macoupin, Morgan, Scott, Greene and Jersey.

Eighth Circuit – The counties of Adams, Schuyler, Mason, Cass, Brown, Pike, Calhoun and
Menard.

Ninth Circuit – The counties of Knox, Warren, Henderson, Hancock, McDonough andFulton.

Tenth Circuit – The counties of Peoria, Marshall, Putnam, Stark and Tazewell.

Eleventh Circuit – The counties of McLean, Livingston, Logan, Ford and Woodford.

Twelfth Circuit – The county of Will.

Thirteenth Circuit The counties of Bureau, LaSalle and Grundy.

Fourteenth Circuit – The counties of Rock Island, Mercer, Whiteside and Henry.

Fifteenth Circuit – The counties of JoDaviess, Stephenson, Carroll, Ogle and Lee.

Sixteenth Circuit – The counties of Kane, DeKalb and Kendall.

Seventeenth Circuit – The counties of Winnebago and Boone.

Eighteenth Circuit – The county of DuPage.

Nineteenth Circuit – The counties of Lake and McHenry.

Twentieth Circuit – The counties of Randolph, Monroe, St. Clair, Washington andPerry.

Twenty-first Circuit – The counties of Iroquois and Kankakee.

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FORM: Application to Sue as a Poor Person

Introduction: Your name

Paragraph 1: Your address, include street and city.

Paragraph 2: The amount and source of your income, for example, $339.00 per
month in AFDC, supplemented by Food Stamps.

Paragraph 3:. List other sources of income not listed in 2.

Paragraph 4: The amount of income you had in the last year.

Paragraph 5: Should be the same as 2, unless you expect your income to go up
or down, in which case you should list what you expect your
income to be.

Paragraph 6: List the names and birthdates of your children and/or others you
support financially.

Paragraph 7: First blank: total value of your possessions;

Second blank: year and make of your car; if you do not have a car,
simply put “none”;

Third blank: value of your car;

Sign your name on both blank lines above where it says “Plaintiff” and print your name
below each signature.

FORM: Petition For Dissolution of Marriage (no children)

Introduction: Your name

Paragraph 2: First blank: Your age.

Second blank: Your address (street and city).

Third blank: The county in which you live.

Fourth and

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Fifth blank: The month and year you began living in Illinois;

Paragraph 3: First blank: Your spouse’s name.

Second blank: Your spouse’s age.

Third blank: Your spouse’s address (street, city, and state)

Fourth and
Fifth blank: Check whether your spouse is or is not a
resident of Illinois.

Paragraph 4: First and
Second blank: Day, month and year of your marriage.

Third blank: The city and state in which you got
married.

Fourth blank: The county in which your marriage was
registered.

Fifth blank: The state in which your marriage was
registered.

Paragraph 5: First and
Second blank: The month and year you and your spouse
separated. If not separated put n/a.

Third blank: The grounds for the divorce: (for example,
extreme and repeated mental cruelty; extreme
and repeated physical cruelty; irreconcilable
differences)

Paragraph 8: List your non-marital property. If there is not enough room, place
the remainder on an additional sheet and refer to it at the end of
Paragraph 8. (for example: “continued on a separate sheet.”)

Paragraph 9: List your marital property. If there is not enough room, place the
remainder on an additional sheet and refer to it at the end of
Paragraph 9. (For example: “continued on a separate sheet.”)

Paragraph 11: List the debts you and your spouse incurred while you were
married. If there is not enough room, place the remainder on an
additional sheet and refer to it at the end of Paragraph 11. (for
example: “continued on a separate sheet.”

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Paragraph 12: Put your maiden or former name in the blank.

Paragraph G Enter any additional relief you want that is not
covered in A through F;

Sign your name on both blank lines above where it says “Plaintiff” and print your name
below each signature

FORM: Judgment of Dissolution of Marriage (no children)

Introduction: First blank: Day of hearing.

Second blank: Month of hearing;

Third blank: Year of hearing;

Fourth blank: Your name:

Place a check in the box that corresponds with how your spouse
was served. CHECK ONLY ONE BOX. If you check the first box,
the first blank should be filled in with the county in which your
spouse was served and the second blank should be filled in with
the state in which that county is located.

Paragraph 2. First blank: Your age.

Second blank: Your address.

Third blank: Name of county in which you reside.

Paragraph 3: First blank: The age of your spouse.

Second blank: Your spouse’s address. If you don’t have an
address put “unknown”.

Third blank: The state where your spouse resides. If you
don’t know the state, put “unknown”.

Fourth and
Fifth blank: check whether your spouse is or is not a
resident of Illinois;

Paragraph 4: First and

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Second blank: The day, month, and year of your marriage.

Third blank: The county in which your marriage was
registered.

Fourth blank: The state in which your marriage was
registered.

Paragraph 5: Month and year on which you and your spouse separated;

Paragraph 6: Grounds on which you are getting a divorce;

Paragraph 9: List marital property as you did in your Petition.

Paragraph 10: List the non-marital property you have in your possession.

Paragraph 11: List the debts as you did in your Petition.

Paragraph 12: List your former name.

Paragraph A: List all the non-marital and marital property you want the court to
award to you which is in your possession.

Paragraph C. List the marital debts for which you want your spouse to be
responsible.

Paragraph E. List your former name.

Paragraph G: List any relief you want the court to order not listed in Paragraphs
A-F.

DO NOT FILL IN THE DATE OR THE SIGNATURE LINE FOR THE JUDGE.

FORM: Notice of Hearing (use only if you want to notify your spouse of the hearing)

First blank: Spouses name and address (include street, city, and state)

Second blank: Your name.

Third blank: Date of hearing.

Fourth blank: Time of hearing. (be sure to put a.m. or p.m.)

Fifth blank: County in which your case is filed.

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Sixth blank: City in which the courthouse is located.

Sign your name on the blank line next to where it says “Plaintiff” and print your name
below the signature.

FORM: Stipulation To Waiver Of The
Two Year Requirement (use only if you have been separated for less than 2 years but
more than 6 months, you are using the grounds of
irreconcilable differences, and your spouse is willing to sign
this form)

Paragraph 1: Date of your marriage.

Paragraph 2: Month and year of your separation.

Sign your name on both blank lines above where it says “Plaintiff” and print your name
below each signature. Your spouse will sign on both blank lines above where it says
“Defendant” and will print his name below each signature.

FORM: Certificate of Mailing Of Judgment Of Dissolution Of Marriage

First blank: Your name.

Second blank: Name of city in which you mailed a copy of the Judgment to your
spouse.

Third blank: Date you mailed a copy of the Judgment to your spouse.

Sign your name on both blank lines above or next to where it says “Plaintiff” and print
your name below each signature.

FORM: Certificate of Mailing Of Notice Of Hearing (use only if you want to notify
your spouse of the hearing)

First blank: Your name.

Second blank: Name of city in which you mailed a copy of the Notice Of Hearing
to your spouse.

Third blank: Date you mailed a copy of the Notice of Hearing to your spouse.

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Sign your name on both blank lines above or next to where it says “Plaintiff” and print
your name below each signature.

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT

__________________ COUNTY

)
______________________ ) _____Application granted
) _____Application denied
Plaintiff, )
)
vs. ) No. _______
)
______________________ ) __________________, 20__
)
Defendant. ) ________________________
JUDGE

APPLICATION TO SUE AS A POOR PERSON

I, _____________________________________, on my own behalf, on oath state:

1. My current address is _________________________________________________.

2. My occupation, source of income, amount of public benefits is ________________.

3. My other sources of income or support are ________________________________.

4. My income for the preceding year was approximately ________________________.

5. The sources and amounts of income I expect to receive in the future are:

______________________________________________________________________
.

6. Person(s) who are dependent on me for support are: ________________________

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_____________________________________________________________________
_____________________________________________________________________.

7. I own no real estate. The total value of all my personal property does not exceed

$___________ in value and consists of clothing and furniture, and other household

items, including a 20____, ____________ motor vehicle, valued at $____________.

8. I filed no applications for leave to sue or defend as a poor person during the

preceding year, and none were filed on my behalf.

9. I am unable to pay the costs of commencing and prosecuting this action.

10. I have a meritorious claim.

WHEREFORE, Applicant prays the Court to permit her/him to commence and prosecute
this action as a poor person under 735 ILCS 5/5-105 of the Code of Civil Procedure.

___________________________________
Plaintiff

Under penalties as provided by law pursuant to Section 5/1-109 of the
Code of Civil Procedure, the undersigned certifies that the statements set forth in this
instrument are true and correct, except as to matters therein stated to be on information
and belief and as to such matters the undersigned certifies as aforesaid that he/she
verily believes the same to be true.

___________________________________
Plaintiff

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT

________________ COUNTY

IN RE THE MARRIAGE OF: )
)
______________________, )
)
Plaintiff, )
)
and ) No. ____-D-____
)
______________________, )
)
Defendant. )

ENTRY OF APPEARANCE
WAIVER AND CONSENT

I, ______________________, hereby enter my appearance in the above-entitled cause

as Defendant therein, and expressly waive the necessity of process of summons and consent

that the same proceedings may be had therein, as fully and with the same force and effect as

though I had been duly and regularly served with process of summons therein in the State of

Illinois, at least 30 days prior to any return day designated by Plaintiff herein or as provided by

law.

I further certify that I am aware that property owned by myself and Plaintiff may be

classified as marital or non-marital property, and I am aware that marital misconduct does not

enter into a judicial division of said property. I waive any right that I have to all of said property

other than that which will be awarded to me in accordance with the terms of the order for

Judgment of Dissolution of Marriage.

I further consent that immediate default may be taken and entered therein
against me upon the filing of this appearance or at any time thereafter, and that an immediate
hearing of said cause may be had without further notice.

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Dated ____________________________________, 20___.

SIGNATURE: ____________________________________

STATE OF __________)
)
County of ___________)

I, _______________________, a Notary Public in and for said County and State, do
hereby certify that ___________________ __________________, personally known to me to
be the same person whose name is subscribed to the foregoing waiver of summons, appeared
before me this day in person, and acknowledged that he signed said appearance as his free
and voluntary act, for the purpose therein set forth.

Given under my hand and Notarial Seal, _____________, 20___.

__________________________________
NOTARY PUBLIC

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT

________________ COUNTY

IN RE THE MARRIAGE OF: )
)
______________________, )
)
Plaintiff, )
)
and ) No. ____-D-____
)
______________________, )
)
Defendant. )

ENTRY OF APPEARANCE
WAIVER AND CONSENT – MILITARY

I _____________________________, hereby enter my appearance in the above-

entitled cause as the Defendant therein, and expressly waive the necessity of process of

summons and consent that the same force and effect as though I had been duly and regularly

served with process of summons therein in the State of Illinois, at least thirty (30) days prior to

any return day designated by the Plaintiff herein, or as provided by law.

I consent that immediate default may be taken and entered herein against me upon the

filing of this appearance or at any time thereafter and that an immediate hearing of said cause

may be had without further notice to me.

I further state that I am over the age of eighteen (18) years and hereby acknowledge and

expressly waive any and all rights that I may be entitled to under the Soldiers’ and Sailors’ Civil

Relief Act (50 U.S.C.A. App. Section 501) as amended.

I further certify that I am aware that property owned by myself and Plaintiff may be

classified as marital or non-marital property, and I am aware that marital misconduct does not

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enter into a judicial division of said property. I waive any right that I have to all of said property

other than that which will be awarded to me in accordance with the terms of the order for

Judgment of Dissolution of Marriage.

Dated ____________________________________, 20___.

SIGNATURE: ____________________________________

STATE OF __________)
)
County of ___________)

I, _______________________, a Notary Public in and for said County and State, do
hereby certify that _____________________________________, personally known to me to be
the same person whose name is subscribed to the foregoing waiver of summons, appeared
before me this day in person, and acknowledged that he signed said appearance as his free
and voluntary act, for the purpose therein set forth.

Given under my hand and Notarial Seal, _____________, 20___.

__________________________________
NOTARY PUBLIC

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT

_____________ COUNTY

IN RE THE MARRIAGE OF: )
)
_____________________, )
)
Plaintiff, )
)
and ) No. ____-D-____
)
_____________________, )
)
Defendant. )

PETITION FOR DISSOLUTION OF MARRIAGE – NO CHILDREN

I, ________________________________, without the assistance of an attorney, ask

this Court for a Dissolution of Marriage. In support of my Petition, I state the following items are

true:

1. I am ____ years of age; reside at ________________________________________.

I have been a resident of the State of Illinois for _________ years. My occupation is

________________________________________________.

2. My spouse’s name is _______________________, he/she is _____ years of age;

he/she resides at ___________________________________; and he/she has been a resident

of the State of Illinois for ______ years. His/her occupation is _________________________.

My spouse is not currently in military service with any of branches of the Armed Forces of the

United States.

3. There are no other petitions for dissolution of marriage pending in any other county

or state.

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4. I am now a resident of the State of Illinois, and have been a resident of the State of

Illinois for more than ninety (90) days next preceding the commencement of this action. I

reside in ___________________ County, Illinois. The jurisdictional requirements of the Illinois

Marriage and Dissolution of Marriage Act therefore exist, and there exist grounds for the

dissolution of the marriage of the parties.

5. My spouse and I were lawfully married on __________________, 20 ___ at

____________________________________________, and the marriage was registered at

____________________ County, in the State of ____________________.

6. My spouse and I have lived separate and apart continuously since ____________

________________, 20 ___ and the reason I want a divorce is: _______________________

________________________________________________________________ as defined by

the Illinois Marriage and Dissolution of Marriage Act.

7. That no children were born to or adopted by my spouse and me or all of our children

are age 18 or older.

8. I am not pregnant.

9. I have in my possession the following items of non-marital property (property I got

prior to our marriage, by inheritance, or by gift). My spouse did not help pay for this property,

and he/she has no legal right to any part of it:_______________________________________

____________________________________________________________________________

__________________________________________________________________________.

10. Our martial property (property we got after our marriage and not by inheritance or by

gift) includes, but is not limited to, the following: _____________________________________

____________________________________________________________________________

____________________________________________________________________________

_______________________________________________________________. I helped pay for

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our marital property.

11. I do not know if my spouse has obtained any marital property or debts since our

separation.

12. Our martial debts (debts we got after our marriage) include, but are not limited to,

the following: ________________________________________________________________

_________________________________________________________________________.

13. My former/maiden name was: ______________________________________.

WHEREFORE, I request:

A. A Judgment of Dissolution of Marriage.

B. That the Court award to me all of the marital and non-marital property now in my

possession.

C. That the Court award to my spouse all of the marital and non-marital property now in

his/her possession.

D. That the Court order my spouse to take responsibility and pay for all legal debts,

liabilities and obligations we got since we got married.

E. That neither party be awarded maintenance.

F. That I be allowed to use my maiden/former name.

G. That _______________________________________________________________

___________________________________________________________________________.

______________________, Plaintiff

Under penalties as provided by law pursuant to Section 5/1-109 of the Code of Civil Procedure,
the undersigned certifies that the statements set forth in this instrument are true and correct,
except as to matters therein stated to be on information and belief and as to such matters the
undersigned certifies as aforesaid that she/he verily believes the same to be true.

________________________, Plaintiff

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE _____________ JUDICIAL CIRCUIT

_________________ COUNTY

IN RE THE MARRIAGE OF: )
)
_________________________, )
)
Plaintiff, )
)
and ) No. ____-D-_____
)
__________________________, )
)
Defendant. )

STIPULATION TO WAIVER OF TWO-YEAR REQUIREMENT

Plaintiff and Defendant hereby agree that the following is true:

1. That we are Husband and Wife, and were married on ____________________,

20____.

2. We have been separated since on or about _______________, 20____; a

continuous period not less than six (6) months.

3. There has been an permanent breakdown of our marriage without hope of

reconciliation and we want to get a divorce without proving that one of us is at fault, and we

waive the normal two-year separation requirement.

4. We both understand the legal effect of this waiver and no one is forcing us to sign it

and we want to be held to this agreement.

______________________________ ________________________________
Plaintiff Defendant

Under penalties as provided by law pursuant to Section 5/1-109 of the Code of Civil Procedure,

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the undersigned certify that the statements set forth in this instrument are true and correct,

except as to matters therein stated to be on information and belief and as to such matters the

undersigned certify as aforesaid that she/he verily believes the same to be true.

_________________________________ ________________________________
Plaintiff Defendant

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ______________ JUDICIAL CIRCUIT

__________________ COUNTY

IN RE THE MARRIAGE OF: )
)
_________________________, )
)
Plaintiff, )
)
vs. ) No. ____-D-____
)
_________________________, )
)
Defendant. )

NOTICE OF HEARING

To: ____________________________________

____________________________________

____________________________________

YOU ARE HEREBY NOTIFIED that a hearing on the Petition for Dissolution of

Marriage filed by __________________ is set for _________________, at _________ ___.m.

at the ______________ County Courthouse, _____________________, Illinois. You may be

present if you wish.

_____________________Plaintiff

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ____________ JUDICIAL CIRCUIT

____________________ COUNTY

IN RE THE MARRIAGE OF: )
)
__________________________, )
)
Plaintiff, )
)
vs. ) No. ____-D-____
)
__________________________, )
)
Defendant. )

CERTIFICATE OF MAILING OF NOTICE OF HEARING

I, _______________________, hereby certify that I mailed a copy of the Notice of

Hearing to the Defendant at his/her last known address by depositing the same in the United

States mail at _______________________, Illinois, postage fully prepaid on

________________, 20____.

______________________, Plaintiff

Under penalties as provided by law pursuant to Section 5/1-109 of the Code of
Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true
and correct, except as to matters therein stated to be on information and belief and as to such
matters the undersigned certifies as aforesaid that she/he verily believes the same to be true.

______________________, Plaintiff

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ________________ JUDICIAL CIRCUIT

___________________ COUNTY

IN RE: THE MARRIAGE OF: )
)
_________________________, )
)
Plaintiff, )
)
and ) No. ____-D-____
)
_________________________, )
)
Defendant. )

JUDGMENT OF DISSOLUTION OF MARRIAGE (NO CHILDREN)

This cause having come up for hearing on the _____ day of _____________, 20__, on

the Petition for Dissolution of Marriage filed by _________________________, and

( ) it appearing that Defendant was personally served with summons in

________________ County, __________________, and was defaulted for failure to

appear or respond;

( ) it appearing that Defendant has filed an Entry of Appearance and consented, in

sincerity and without fraud or collusion to an immediate hearing;

( ) that on due inquiry, Defendant could not be found, and service was obtained in

accordance with 735 ILCS 5/2-206 and 2-207;

and the Petition herein taken as confessed by said Defendant, the Court having heard the

evidence and being fully advised in the premises does find:

1. That this Court has jurisdiction of the subject matter herein and the parties hereto.

2. That Plaintiff is ____ years old. She/He currently lives at ____________________,

Illinois, in ________________ County, and has lived in Illinois for more than 90 days prior to the

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filing of her Petition.

3. That Defendant is ____ years old. His/Her last known address is _____________

____________, State of ______________________and has been a resident of Illinois since

_____________________, 20 ______. Defendant is not currently in military service with any of

the Armed Forces of the United States.

4. That the parties were lawfully married on _____________, 20 ___ and that said

marriage was registered in ___________________County, __________________________.

5. That the parties have been separated since _______________________, 20 ____.

6. That the grounds of __________________________________________________

have been proven within the meaning of the Illinois Marriage and Dissolution of Marriage Act.

7. That no children were born to or adopted by the parties as a result of their

relationship.

8. That Plaintiff is not now pregnant.

9. That since the marriage of the parties, the parties acquired marital property,

including:

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________;

that Plaintiff has contributed to the acquisition and preservation of the marital property through

her/her own efforts and frugalities.

10. That Plaintiff has in her/his possession the following items of non-marital

property:____________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________.

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11. That debts and obligations were incurred by the parties, as a result of the marriage

relation, including: _____________________________________________________________

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____________________________________________________________________________

12. That Plaintiff’s former name was ______________________________________

IT IS THEREFORE ORDERED, ADJUDGED AND DECREED BY THE COURT AS

FOLLOWS:

A. That the bonds of matrimony presently existing between Plaintiff and Defendant be

and the same are hereby dissolved and the parties are granted a Judgment of Dissolution of

Marriage.

B. That Plaintiff shall have as her sole and exclusive property free of homestead, dower,

or any right of Defendant all property presently in her/his possession,

including:____________________________________________________________________

____________________________________________________________________________

__________________________________________________________________________.

C. That Defendant shall assume full responsibility for all the following legal debts and

obligations incurred by the parties, or either of them, as a result of this marriage relation, and

hold Plaintiff free and harmless therefrom including: _________________________________

____________________________________________________________________________

__________________________________________________________________________.

D. That each of the parties is forever barred from claiming maintenance from the other,

having waived the right thereto, and from any and all other rights, claims, title or interest

whatsoever against the other party or in or to the property of the other, whether the property be

real, personal or mixed or whether it be now owned or hereafter acquired, especially rights of

dower, homestead or other rights of inheritance.

E. That Plaintiff is permitted to resume her former name of ____________________.

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F. That this Court shall retain jurisdiction of this cause until the terms of this Judgment

have been fully complied with in all respects.

G. __________________________________________________________________

___________________________________________________________________________

DATE: ____________________ ENTER: ______________________________
JUDGE

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STATE OF ILLINOIS

IN THE CIRCUIT COURT OF THE ____________ JUDICIAL CIRCUIT

____________________ COUNTY

IN RE THE MARRIAGE OF: )
)
__________________________, )
)
Plaintiff, )
)
vs. ) No. ____-D-____
)
__________________________, )
)
Defendant. )

CERTIFICATE OF MAILING OF JUDGMENT OF DISSOLUTION OF MARRIAGE

I, _______________________, hereby certify that I mailed a copy of the Judgment of

Dissolution of Marriage to the Defendant at his/her last known address by depositing the same

in the United States mail at _______________________, Illinois, postage fully prepaid on

________________, 20____.

______________________, Plaintiff

Under penalties as provided by law pursuant to Section 5/1-109 of the Code of
Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true
and correct, except as to matters therein stated to be on information and belief and as to such
matters the undersigned certifies as aforesaid that she/he verily believes the same to be true.

______________________, Plaintiff

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