This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts.
STATE OF ILLINOIS,
CIRCUIT COURT
COUNTY
CERTIFICATION FOR
EXEMPTION FROM E-FILING
For Court Use Only
Instructions
Plaintiff / Petitioner (First, middle, last name)
v.
Defendant / Respondent (First, middle, last name)
Directly above, enter
the name of the
county where the case
was filed.
Enter the name of the
person who started the
lawsuit as
Plaintiff/Petitioner.
Enter the name of the
person being sued as
Defendant/Respondent
Case Number
Enter the Case
Number given by the
Circuit Clerk or leave
this blank if you do
not have one.
In 1, check the reasons
you are asking to file
by mail, in person, or
by other means. You
should check all that
apply.
You are exempt from
e-filing and you do not
need to file this
Certification if:
you are in jail or
prison;
you are filing a will;
you are filing into a
juvenile case; OR
your disability
prevents you from e-
filing.
1.
I am not able to e-file documents in this case for the following reasons (check all that apply) :
I am representing myself and do not have the Internet or a computer in my home.
My only access is through a public terminal at a courthouse, library, or other location.
This poses a financial or other hardship.
I am representing myself and have trouble reading, writing, or speaking in English.
I am filing a document in a sensitive case, such as a petition for an order of protection
or a civil no contact/stalking order.
I tried to e-file my documents, but I was unable to complete the process because the
equipment or assistance I need is not available.
2.
Illinois Supreme Court Rule 9(c)(5) allows for an exemption from e-filing for good
cause. For the above reasons, I need a good cause exemption from e-filing for my
entire case or until I am able to e-file.
Under the Code of
Civil Procedure, 735
ILCS 5/1-109, making
a statement on this
form that you know to
be false is perjury, a
Class 3 Felony.
I certify that everything in the Certification for Exemption from E-filing is true and correct. I
understand that making a false statement on this form is perjury and has penalties provided
by law under 735 ILCS 5/1-109.
/s/
Your Signature
Street Address
Print Your Name
City, State, ZIP
Telephone
Email
After you finish this
form, sign and print
your name.
Enter your complete
address, telephone
number, and email
address, if you have
one.
GETTING COURT DOCUMENTS BY EMAIL: You should use an email account that you do not share with anyone else and that you check
every day. If you do not check your email every day, you may miss important information, notice of court dates, or documents from other parties.
EW-C 3401.3
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(08/20)
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