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STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT FORD/MCLEAN COUNTY ) ) Plaintiff, ) ) vs. ) ) ) ) Defendant. ) Case No. NOTICE OF REJECTION OF AWARD TO: Clerk of the Court, Eleventh Judicial Circuit Notice is given that rejects the Award of the Arbitrators entered in this cause on , 20 and requests a trial before the Court. I certify that I have paid the appropriate Rejection Fee (or have filed a Rule 298 poor person waiver of such fee). Name: Attorney for: Address: City: Telephone: PROOF OF SERVICE On , 20 , I, , on oath state that: I served this Notice by delivering a copy personally to all parties of record. I served this notice by mailing a copy to all parties of record and depositing the same in the U.S. mail at Paxton/Bloomington, Illinois, with the proper postage prepaid. SUBSCRIBED AND SWORN TO before me this day of , 20 . NOTARY PUBLIC