Form IL 442-0290 Sample Verified Response for Housing Charges - Illinois

Form IL442-0290 is a Illinois Department of Human Rights form also known as the "Sample Verified Response For Housing Charges". The latest edition of the form was released in November 22, 2011 and is available for digital filing.

Download a PDF version of the Form IL442-0290 down below or find it on Illinois Department of Human Rights Forms website.

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SAMPLE VERIFIED RESPONSE FOR HOUSING CHARGES
STATE OF ILLINOIS
DEPARTMENT OF HUMAN RIGHTS
IN THE MATTER OF:
)
)
(Name)
)
)
COMPLAINANT(S),
) CHARGE NO.
AND ) HUD NO.
)
(Name)
)
)
RESPONDENT(S).
)
NOW COMES the Respondent(s) (list each Respondent responding), ____________________
_____________________, and responds to the Charge of Discrimination filed against it (them) by
the Complainant(s)_____________________, as follows:
1. With regard to Paragraph 5 (Address and location of the property in question (or if no property
is involved) the city and state where the discrimination occurred):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (5) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
2. With regard to Paragraph 7 (The following is a brief and concise statement of the facts
regarding the alleged violation):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (7) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
3. With regard to Paragraph 9 (Types of Federal funds identified):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (9) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
WHEREFORE, Respondent(s) requests that the Charge be dismissed in its entirety.
Respectfully submitted,
(Respondent(s))
By:
(Name/Title)
Now you must verify your responses and provide certification as indicated on page 2:
Page 1 of 2, VR4 Sample Hsg 11/22/2011, IL 442-0290
SAMPLE VERIFIED RESPONSE FOR HOUSING CHARGES
STATE OF ILLINOIS
DEPARTMENT OF HUMAN RIGHTS
IN THE MATTER OF:
)
)
(Name)
)
)
COMPLAINANT(S),
) CHARGE NO.
AND ) HUD NO.
)
(Name)
)
)
RESPONDENT(S).
)
NOW COMES the Respondent(s) (list each Respondent responding), ____________________
_____________________, and responds to the Charge of Discrimination filed against it (them) by
the Complainant(s)_____________________, as follows:
1. With regard to Paragraph 5 (Address and location of the property in question (or if no property
is involved) the city and state where the discrimination occurred):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (5) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
2. With regard to Paragraph 7 (The following is a brief and concise statement of the facts
regarding the alleged violation):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (7) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
3. With regard to Paragraph 9 (Types of Federal funds identified):
Respondent(s) admits that…Respondent(s) denies that…Respondent(s) admits/denies all
the allegations in Paragraph Seven (9) of the instant charge…Respondent(s) lacks
sufficient knowledge to answer and demands a more definite statement from
Complainant(s) that…Respondent(s) denies that it discriminated against Complainant(s).
WHEREFORE, Respondent(s) requests that the Charge be dismissed in its entirety.
Respectfully submitted,
(Respondent(s))
By:
(Name/Title)
Now you must verify your responses and provide certification as indicated on page 2:
Page 1 of 2, VR4 Sample Hsg 11/22/2011, IL 442-0290
SAMPLE OF VERIFICATION STATEMENT
Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure [735
ILCS 5/1-109], 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 or she verily believes the same to be true.
_____________________________________________
_______________
(Signature)
(Date)
____________________________________________
(Name PRINTED)
Notes:
1. Each Respondent must file a verified response and sign a verification statement. However,
more than one Respondent can sign the same verification statement.
2. An employee or officer of a board or association may sign a verification statement on behalf of
him or herself personally and on behalf of his/her employer/board/association, if both are
charged. In this case, the verification statement must name all entities that the person is
signing on behalf of.
3. A person with knowledge of the facts must sign the verification. Unless Respondent(s)’s
attorney has first-hand knowledge of the facts of the charge, or is an employee of the
Respondent(s), Respondent(s)’s attorney cannot sign.
4. If Respondent(s)’s attorney signs the response, then Respondent(s)’s attorney must provide
his/her name, law firm name, address, and telephone number on the response.
In order for the Verified Response to be complete, a copy of the response must be served on the
Complainant(s), and you must indicate to the Department by a Certificate of Service or other
written means that you have done so.
SAMPLE CERTIFICATE OF SERVICE
CERTIFICATE OF SERVICE
The undersigned certifies that a copy of the foregoing Verified Response to the charge of
discrimination was served upon:
Complainant(s) Name(s) _______________________________
Address ____________________________________________
By depositing same in the U.S. Mail at (address)
, (city)
, IL (zip code) on the
day of
, 201_.
(signature)
(name)
Page 2 of 2, VR4 Sample Hsg 11/22/2011, IL 442-0290

Download Form IL 442-0290 Sample Verified Response for Housing Charges - Illinois

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