"Certificate of Service" - Illinois

Certificate of Service is a legal document that was released by the Illinois Department of Labor - a government authority operating within Illinois.

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  • Fill out the form in our online filing application.

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STATE OF
____________ )
)
(Name of State)
)
COUNTY OF____________ )
(Name of County) )
CERTIFICATE OF SERVICE
I ___________________________ , Claimant, affirm, certify or on oath state, that I
(Name)
served notice of the Wage Claim Complaint filed against
________________________ or their agents appointed to receive service of process
(Name of Individual/ Company/Agent)
by attaching/enclosing a copy of the Wage Claim Complaint and any
additional documentation and sending by electronic mail (email) with a “read”
confirmation or in an envelope addressed to _________________at______________________
(Name of Respondent)
(Address)
_______________, _______, ____________ having mailed the envelope to be served
(City)
(State)
(Zip Code)
by U.S. mail/private courier, with postage prepaid at__________________________,
(Circle One)
(Address of Post Office or Courier)
_____________, ________, ________ on the ________________, 20____ prior to 4:30 p.m.
(City)
(State)
(Zip Code)
(Date and Month)
______________________________
(Signature)
_____________________________________________
(Printed Name)
STATE OF
____________ )
)
(Name of State)
)
COUNTY OF____________ )
(Name of County) )
CERTIFICATE OF SERVICE
I ___________________________ , Claimant, affirm, certify or on oath state, that I
(Name)
served notice of the Wage Claim Complaint filed against
________________________ or their agents appointed to receive service of process
(Name of Individual/ Company/Agent)
by attaching/enclosing a copy of the Wage Claim Complaint and any
additional documentation and sending by electronic mail (email) with a “read”
confirmation or in an envelope addressed to _________________at______________________
(Name of Respondent)
(Address)
_______________, _______, ____________ having mailed the envelope to be served
(City)
(State)
(Zip Code)
by U.S. mail/private courier, with postage prepaid at__________________________,
(Circle One)
(Address of Post Office or Courier)
_____________, ________, ________ on the ________________, 20____ prior to 4:30 p.m.
(City)
(State)
(Zip Code)
(Date and Month)
______________________________
(Signature)
_____________________________________________
(Printed Name)