STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT COUNTY, ILLINOIS Estate of No. INVENTORY The following is the * inventory of real and personal property of the (decedent) (minor) (disabled person) that has come to the knowledge of the legal representative of this estate and of any cause of action on which there is right to sue: ITEM NO. DESCRIPTION AND QUALITY** The approximate value of personal estate at date of death is $ . The approximate annual income from real estate is $ . The bond of the individual representative is $ . (corporate surety) (individual surety) (surety waived) APPROVED , 20 Executor Administrator Guardian Judge on oath states that the above inventory is complete and correct. Attorney (s) Signed and sworn to before me Notary Public A-11 APPENDIX K 04/95 American LegalNet, Inc. www.FormsWorkFlow.com