In The Circuit Court For The Seventh Judicial Circuit of Illinois Sangamon County, Springfield, Illinois IN THE ESTATE OF: (Deceased) } to (Date) Case Number: CLAIM NOTICE Notice is given of the death of (Name) . Letters of Office were issued on (Name) (Address) (City/State/Zip) as whose attorney is (Name) . (Address) (City/State/Zip) Claims against the Estate may be filed in the Office of the Clerk of the Circuit Court, Sangamon County Courthouse, Springfield, Illinois, 62701, or with the Representative, or both, within 6 months from the date of the first Publication of this Notice. Any Claim not filed within that period is barred. Copies of a Claim filed with the Clerk of the Circuit Court must be mailed or delivered to the Representative and to the attorney within 10 days after it has been filed. Date Name: Attorney for: ARDC No: Address: City: State: Zip code: Area Code/Telephone: American LegalNet, Inc. www.FormsWorkFlow.com