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ELEVENTH JUDICIAL CIRCUIT COURT McLEAN COUNTY, ILLINOIS ) Petitioner ) vs. ) Case Number: ) ) Respondent ) MOTION TO Petitioner / Respondent moves to entered on 200__. Petitioner-Defendant states the following as reasons for 1) 2) 3) 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. DATE Signature