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until paid, payable ssmi-annually in advance. And we further agree to give
any additional security which said county superintendent may at any time re-
quire ; and no extension of the time of payment, with or without our knowledge,
by the receipt of interest or otherwise, shall release us or either of us from the

obligation of payment. [seal.]

[seal.]

[seal.]



3. certificate of county superintendent in appeals.

Office of County Sup't, \

County, 18... /

To , State Supt. Pub. Inst.:

Sir : I transmit, herewith, a full and correct statement of the facts, and the

documentary evidence presented tome, in the case of vs , together

with my decision thereon, from which, appeal has been taken to the state de-
partment.

I certify that the accompanying statement is correct, to the best of my know-
ledge and belief.

County Sup't, County.

—16



226 roKMS OF school instkijments.

4. renewal of teacher' s certificate.

Office of County Sup't, )

County, , 18. ...J

The within certificate is hereby renewed, and will be good and valid in this

county during ... year... from the date hereof.

County Sup^t County.



5." revocation of certificate.

Office of County Sup't, ")
County, , 18... j

In virtue of the aiithority conferred by the 50th section of the amended school
law of 1865, and for good and sufficient cause to me appf^aring after careful
investigation, and in the belief that the public good and official duty alike re-
quire it, I, county superintendent of schools of county, state of

Illinois, do hereby revoke and cancel the certificate of , a teacher, now

of the county and state aforesaid. Said certificate bears date 18 ,

being of the grade, and signed by , county superintendent of said

county. From and after the date hereof no public school funds can lawfully

be paid to the said _..., for his services as teacher, until he shall again

become the possessor of a legal certificate. All school officers, and the public,
will take due notice hereof, and govern themselves accordingly.

Dated this day of 18

County Superintendent County.

[The foregoing form of revocation may be used when the teacher refuses to
deliver up his certificate, and publicity is required. In other cases, where the
cause or offence is not flagrant, and the instrument is quietly surrendered on
request of the superintendent, none but the parties immediately concerned need
be apprised of the transaction. Seepage 113, ««<£.]



6. MORTGAGE BY HUSBAND AND WIFE TO COUNTY SUPERINTENDENT.

This indenture, made this day of , a. d. 18..., between A. B., and

C. D., wife of the said A. B., party of the first part, and E. P., county superin-
tendent of schools of the county of , and his successors in office, party

of the second part, Witnessetli : That the party of the first part, for and in con-
sideration of the sum of dollars, to them in hand paid by the party of

the second part, the receipt whereof is hereby acknowledged, have bargained,
sold, aliened, released, conveyed and confirmed, and by these presents do bar-
gain, release, sell, convey and confirm unto the said party of the second part,
forever, all that certain tract of land known and described as follows to wit:
\_IIere insert description of land."] Together with all the tenements, heredita-
ments and appurtenances thereunto belonging or in anywise appertaining, and
also all the estate, right, title and interest, dower and right of dower, property
possession, claim and demand whatsoever, of the said party of the first part.

And for the consideration aforesaid, the party of the first part hereby waives
and releases, confirms and transfers, and forever relinquishes to the said party
of the second part, all right, interest or title they now have or may hereafter
acquires, in and to the real estate hereinbefore described, by virtue of a law of
the state of Illinois, approved February 11th, a. d. 1851, entitled "An act to
exempt homesteads from sale on execution," and all laws amendatory thereof;
to have and to hold the above mentioned and described premises, with the ap-
purtenances thereunto belonging, unto the said party of the second part, for-
ever.

This conveyance is intended as a mortgage to secure the payment of the sum

of dollars in years from the date hereof, together with interest at

the rate of ...per cent., payable semi-annually in advance, according to the
condition of a certain promissory note bearing even date herewith, executed



FORMS OF SCHOOL ' INSTEUMENTS.



227



by the said A. B. to the said party of the second part; and these presents shall
be void if such payment be made. But in case default shall be made in the
payment of the principal or interest, or any part thereof, at the time and in the
manner that the same shall become due and payable by the terms of these
presents, as above provided, then the party of the second part is hereby em-
powered to sell the premises above described, with all and every of the appur-
tenances, or any part thereof, in the manner prescribed by law, and out of the
money arising from such sale to retain the said principal and interest, together
with the costs and charges in making such sale, and the overplus, if any there
be, shall be paid by the party making such sale, on demand, to the party of the
first part, their heirs or assigns. And the said A. B., for himself, his heirs,
executors and administrators, doth covenant and agree to pny unto the said
party of the second part, the said sum of money and interest as above men-
tioned and as expressed in the conditions of the said note.

In witness whereof the party of the first part have hereunto set their hands

and seals this day of a. d. 18....

A. B. [seal.]
C. D. [seal,]

State op Illinois, ")
County. j

Before me, the undersigned, , within and for the county aforesaid,

came , who personally known to me as the real person... by whom

and in whose name the above conveyance was executed, and by whom and in
whose name the same is proposed to be acknowledged, and who then severally

acknowledged signatures thereunto to be free and voluntary act

and deed, for the purpose of waiving and releasing all right, title and interest
in and to said land by virtue of the homestead exemption laws of said state,

and for all other purposes therein expressed ; and the said ..., being by me

first examined separate and apart from her said husband, and the contents of
said conveyance being first made known to her, acknowledged that freely and
voluntarily, without any compulsion or coercion from her said husband, she
executed the same and forever released and waived all right, interest, or title to
the said real estate, by virtue of the homestead exemption laws of said state,
relinquished all her right to the claim of dower in and to the lands and tene-
ments in said conveyance described, and sold, transferred, and conveyed all her
title in fee simple or right by inheritance in and to the real estate aforesaid,
and that she does not wish to retract the same.

Given under my hand and seal this day of , A, D. 18....



Y. magistrate's report to county sup't.

Report of the docket of magistrate, in township ..., range ..., county of

, state of Illinois, made on the... day of 18....



Names of persons Date of
fined. 1 fine.



Amount
of fine.



Amount
Collected.



Ain't transmitted
to county sup't.



Name of ofiBcer.



Magistrate.

To , County BupH.

State of Illinois, )

County. J ■ I, , on oath, say that the above statement

by me rendered, is correct. This day of 18

, Magistrate.

[ The party making this report, being himself a justice of the peace, it is
deemed suflScient for him to vouch for its correctness on his own official oath as
a magistrate.]



228 FORMS OF SCHOOL EN^STKinMENTS.

8. stjpeeixtexdest's account agaixst county foe services.

, 18 County,

To Dr.

For days of service rendered as county superintendent of schools,

@ S3, 00 per day, S

I, , on oath, state that the above account by me rendered against

county, is correct and true.

Sup't Schools, said county.



Subscribed and sworn to before me this



daj- of A. D. 18....



}



y. MORTGAGE TO TRUSTEES.

This indenture, made this day of ....... a. d., 18..., between A.B. and C. D.,

wife of A. B., party of the first part, and the board of trustees of township ,

range , in the county of and state of Illinois, party of the second part,

Witnesseth: That the party of the first part do hereby grant, convey and transfer
to the party of the second part, for the use of the inhabitants of said township,
the following described real estate, to-wit: [_IIere insert description of premises.^
Which real estate, the party of the first part declares to be in mortgage for the
payment of dollars loaned to the party of the first part, and for the pay-
ment of all interest that may accrue thereon, to be computed at the rate of ...
per cent, per annum, payable semi-annually in advance, until paid : and the
party of the first part does hereby covenant to pay the said sum of money in

years from the date hereof; and the party of the first part hereby covenant

that they have a good and valid title to said estate, and that the same is free
from all incumbrance; the party of the first part agrees to pay all taxes and
assessments which may be levied on said estate : and they also agree to give
any additional security that may at any time be required by the party of the
second part; and if said estate be sold to pay said debt, or any part thereof, or
for any failure or refusal to comply with or perform the conditions or covenants
herein contained, the party of the first part agrees to deliver immediate posses-
sion of the premises. And for the consideration aforesaid, the party of the
first part hereby waives and releases, confirms and transfers, and forever re-
linquishes to the said party of the second part, all right, interest or title they
now have, or may hereafter acquire, in and to the real estate hereinbefore de-
scribed, by virtue of the law of the state of Illinois, approved February 11,
1851, entitled "An act to exempt homesteads from sale on execution."' and all
laws amendatory thereof. And in consideration of the premises, C. D., wife of
the said A. B., doth hereby release to the said party of the second part all her
right and title to dower in the aforesaid premises for the purposes aforesaid.

In witness whereof the party of the first part have hereunto set their hands

and seals, this day of , a. d. 18

A. B. [seal.]
C. D. [seal.]



State op Illinois,
County.



i ss.

Before me, the undersigned within and for the

county aforesaid, came , who personally known to me as the real per-
son, by whom and in whose name the above conveyance was executed, and by
whom and in whose name the same is proposed to be acknowledged, and who
then severally acknowledged signature thereto to be free and volun-
tary act and deed for the purpose of waiving and releasing all right, title and
interest in and to said land by virtue of the homestead exemption laws of said

state, and for all other purposes therein expressed ; and the said being by

me first examined separate and apart from her said husband, and the contents



POEMS OF SCHOOL INSTRUMENTS. 229

of said conveyance being first made known to her, acknowledged that freely
and voluntarily, without any compulsion or coercion from her said husband
she executed the same, and forever released and waived all right, interest or
title to said real estate, by virtue of the homestead exemption laws of said
state, relinquished all her right to the claim of dower in and to the lands and
tenements in said conveyance described and sold, transferred and conveyed all
her title in fee simple or right by inheritance in and to the real estate afore-
said, and that she does not wish to retract the same.

Given under my hand and seal this day of , a. d., 18....

[SEAIi.]



10. TOWNSHIP treasurer's BOND.

State op Illinois, \
County. J

Know all men by these presents, that we, A. B., CD., and E. F., are held and

• firmly bound, jointly and severally, unto the board of trustees of township ,

range , in said county, in the penal sum of dollars, for the payment of

which we bind ourselves, our heirs, executors, and administrators, jointly and
severally, firmly by these presents.

In witness whereof, we have hereunto set our hands and seals, this dav of

,A. D. 18....

The condition of the above obligation is such, that if the above bounden
A. B., township treasurer of township , range , in the county afore-
said, shall faithfully discharge all the duties of said office, according to the
laws which now are or may hereafter be in force, and shall deliver to his suc-
cessor in office all moneys, books, papers, securities, and property in his hands
as such township treasurer, then this obligation to be void ; otherwise to re-
main in full force.

A. B. [seal.]
Approved and accepted by C. D. [seal.]

G. H 1 E. P. [seal.]

I. J. y Trustees.
K. L.



11. SEMI-ANNUAL EXHIBIT TO DIRECTORS.

In compliance with the requirements of section 63, of the amended school

law of 1865, the undersigned, treasurer of township. ..k.., range , in

county, hereby certifies that the following is a true and correct statement of

the amount of funds now in his hands, belonging to district No , in said

township, viz :

Amount of state and county fund $

" " interest on township fund

" " district tax fund



Dated this day of , A. d. 18

Township Treasurer.



12. RECEIPT TO TOWNSHIP TREASURER.

Received ....18 , of the treasurer of township , range..

county of , the sum of dollars, on account of district No.

township , range , in the county of



230 FORMS or SCHOOL INSTEUMEKTS.

13. TOWNSHIP ELECTION NOTICE.

Notice is hereby given, that on Monday, the ... day of next, at ,

in township No. ..., range .,., county, Illinois, an election will be held for...

school trustee. ..for said township. Which election will be opened at... o'clock,
... M., and will continue open until ... o'clock, ... M., of the same day.

By order of the trustees of schools of said township.

Toivnship Treasurer^

Dated 186....



14. POLL BOOK.

List of voters at an election held at , in township No , range No ,

county, Illinois, on Monday, the ... day of , 18....

State op Illinois, \

County. j

We, , , , judges, and , clerk, do solemnly swear

that we will perform the duties of judges and clerk, according to law and the
best of our abilities ; that we will studiously endeavor to prevent fraud, deceit
and abuse in conducting the same.



■ Judges of election.
Clerk of election.
Subscribed and sworn to before me this ... day of 18.



No.



Names of Voters



15. TALLY LIST.

Tally list of an election held at , in township No. ..., range No. ...,

in the county of 111., for school trustee for said township, on the ... day

of , 18....



Names of persons voted for.



Tallies.



16. RETURNS OP TOWNSHIP ELECTION.



At an ELECTION held at , in township No. ..., range No. ..., in the

county of , Ills., on the ... day of 18..., the following persons re-
ceived the number of votes set opposite to their respective names, for the office
of school trustee of said township :



Names of persons voted for.



Whole number of votes cast for each person.



Certified by us,

'Judges of election.
Attest,

Clerk of election.



FOKMS OF SCHOOL IISTSTEUMENTS. 231

17. NOTE TO TOWNSHIP TREASURER.

f 18

after date, for value received, we, jointly and severally, promise to

pay to the board of trustees of schools of township , range , in the

county of , for the benefit of the inhabitants of said township, the sum

of dollars, with interest thereon, at the rate of per cent, per annum,

from date until paid, payable semi-annually in advance. And we further
agree to give any additional security which said trustees may at any time re-
quire; and no extension of the time of payment, with or without our know-
ledge, by the receipt of interest or otherwise, shall release us or either of us
from the obligation of payment. [seal.]



.[seal.]
.[seal.]



18. semi-annual statement to trustees.

. As required by the 63d section of the amended school law of 1865, the under-
signed, treasurer of township , range , county, herewith lays before

the boardof trustees of said township, a true and correct statement of the amount
of interest, rents, issues and profits that have accrued on the lands and funds
of said township since the last semi-annual meeting, together with the present
condition of said funds, and the amount now on hand, viz:

Amount of interest on township fund, received f

" " rents on townshijj lands, received

" " state fund on hand

" " interest on county fund on hand ,

[Add other items as the case may require.]

Dated this day of a. d. 18

Toivnship Treasurer.



/



19. CERTIFICATE OF TOWNSHIP MAP.



In compliance with the requirements of the 33d section of the amended
school law of 1865, the undersigned, president and clerk of the board of town-
ship trustees of schools, of township , range , in county, Illi-
nois, do hereby certify that the accompanying map is a true and correct plat
of the school districts in said township, as now organized.

Dated this day of , A. d. 18...

Clerk. President of the Board.



20. directors' bond for BORROWED MONEY.

Know all men by these presents, that school district, No , in township

No , range No...., in county, state of Illinois, is indebted unto in the

sum of dollars, for money borrowed, according to the instructions of the vo-
ters of said district, expressed by a vote as prescribed by the forty-seventh section

of the school law of 1865, to be paid in year. ..from date, with interest

thereon from the date hereof, at the rate of.. .per cent, per annum, interest pay-
able annually.

Dated this day of , 18....

In witness whereof, we, the school directors of said district, have hereunto

set our hands and seals. [seal.]

[seal.]

[seal.]



232 FOEMS OF SCHOOL INSTRUMENTS.

21. DISTRICT ELKCTION NOTICE.

Notice is heerby given, that oq Monday, the day of 18 , an

election will be held at , in school district No , township ,

range , county of , and state of Illinois, for the purpose of electing

school director... for said district. The polls will be opened at o'clock

M., and closed at o'clock M., of the same day.

Dated this day of 18



Scliool Directors.



[Notices of meetings to vote on various business questions may be in substan-
tially the same form, except that such meetings are not required to be held on
Monday, but may be held on any other day of the week. The various ques-
tions to be voted on should be clearly stated, and it is recommended that each
question or proposition be voted upon separately. The poll book, tally list, and
returns of district elections, are substantially the same as of township elections,
forms for which have already been given.]



22. directors' tax certificate.

We hereby certify, that we require the rate of to be levied, for school

purposes, on all the taxable property of our district, for the year 18 , and

also that the following is a list of tax payers in said district.

(Directors of District No
T. R County of.
and state of Illinois.

[The foregoing certificate must be returned to the township treasurer on or
before the first Monday of September, and to it there must be attached a list of
the tax-payers of the district, with the names written out in full, and in alpha-
betical order.]



23. order on township treasurer.

% 18

The treasurer of township , range , in the county of , will pay

to or order, out of any funds in his hands belonging to district No ,

township , range , in said county, and not otherwise appropriated, the

sum of dollars. \_Here insert for what the money is paid. '\



Directors of said district.



[ It is safer to make the money payable to order instead of bearer. On receiv-
ing the money the payee will endorse his name on the order.]



FORMS OF SCHOOL INSTRUMENTS. 233

24. PERMIT OF TRANSFER.

Consent is hereby given for and , etc., being residents of dis-
trict No ,, township....... range , county, and of lawful school age,

to attend the free school taught in district No , township , range ,

county, until the. ..day of.f a. d. 18

Dated this day of. , a. d. 18

(Directors of Dist. No... "j Directors of Dist. No...
T.....R... county of yT.....R county of
and state of Illinois. j and state of Illinois .

[ The permit should first be signed by the directors of the district where the
pupils reside, and then by the other directors — one form will thus answer for
both.]



25. contract between teacher and directors.

Article of agreement made and entered into between , a school

teacher, of , county of , and state of Illinois, and , school di-
rectors of district No , township No , range No , county of

, and state of Illinois, and their successors in office.

The said hereby agrees to teach the public school in said district for

the term of weeks, commencing on the day of 18 , and

that will faithfully and impartially govern and instruct the children and

youth who may attend the same ; that will refrain from every species of

profanity and improper conduct while in their presence; will institute no cruel
or unusual mode of punishment in the administration of discipline, and will
promptly report to the directors aforesaid, or their successors in office, the
names of all scholars who may be guilty of refractory or incorrigibly bad
conduct.

The said ;. further agrees that he will strictly conform to the rules and

regulations established by said board of directors for the government of said
school, and will faithfully perform all the duties required of by the pro-
visions of sections fifty-two and fifty-three of the school law.

The said school directors as aforesaid, or their successors in office, in

the name and in behalf of the district aforesaid, hereby agree to keep the
school house in which said school is to be taught, in good repair, and to see that
it is furnished with the necessary fuel and appendages for the comfort and con-
venience of the teacher and pupils, and to pay the said ...... for services as

teacher, the sum of dollars per month, of four weeks, of school

days, of hours each : Provided., That in case the said should be dis-
missed from said school by the said directors or their successors in office, for
incompetency, cruelty, negligence, or immorality, or a violation of any of the

stipulations of this contract, or in case certificate should be revoked by

the county superintendent, shall not be entitled to compensation from

and after such dismissal or revocation.

In Testimony Whereof We have hereunto subscribed our names this

day of , 18 , Teacher.



y Directors,



234 FOEMS OF SCHOOL INSTKMENTS.

26. RECEIPT FOR TEACHER'S SCHEDULE.

School District No

J T R...7t.... county of

, 18...

Received of A. B., teacher in the above named district, schedule of school

taught by him, commencing on the ...day of a. d. 18...., and ending on the

... day of A. D. 18..., on ■which schedule there is due said A. B, the sum of

dollars. ' 0. D.,^

E. F., \ Directors.
G. H.J
[ By naming in the receipt the amount due on the schedule, the teacher is
protected in case of the loss of the schedule.]



27. CERTIFICATE OP UNION DISTRICT.

We the undersigned, school directors of districts No , and No , in town-
ship , range , in county, and State of Illinois, do hereby cer-
tify, that in pursuance of the authority vested in us by the 35th section of the
school law of 1865, we have this day united and consolidated the above named
districts, and formed therefrom a new district, under the name and style of

Union District No Township , range , of said county and State :

And we do further certify, that in accordance with the authority aforesaid, we

have appointed , , , as the first board of directors of

said Union District : And that said , , , having been

severally notified of their said appointment, and having duly accepted the same,

the separate boards of directors of districts No and No aforesaid, are

hereby declared dissolved.

G-iven under our hands this day of , A. D. 18

1 Directors of ^ Directors of
District No.... I District No....,
T. R )T. ,R



[ The author is indebted to the courtesy of 0. S. Webster, Esq., attorney at law,
and superintendent of schools for Sangamon county ; Messrs. Adams, Blackmer and
Lyon, publishers, Chicago; and Messrs. Johnson & Bradford, booljsellers, Springfield,


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Online Librarystatutes Illinois. LawsSchool laws of Illinois → online text (page 25 of 26)