194 STATE OF ILLINOIS JUDICIAL, CIRCUIT IN THE CIRCUIT COURT OF THE COUNTY - IN PROBATE ■ In the Matter of the Estate of NO. INVENTORY The following is the (original, amended or supplemental) inventory of the real and personal property of the that (decedent, minor or disabled person) has come to the knowledge of the legal representative of this estate and of any cause of action on which there is a right to sue: QUANTITY REAL ESTATE (Legal Description, Improvements, and Encumbrances Thereon) VALUE (Dollars) American LegalNet, Inc. www.USCourtForms.com TOTAL VALUE QUANTITY PERSONAL PROPERTY [Goods and Chattels] VALUE American LegalNet, Inc. www.USCourtForms.com ESTIMATED TOTAL VALUE American LegalNet, Inc. www.USCourtForms.com BONDS Date of Issuance Name of Obligor Date of Maturity Total Face Value Interest Rate - % Kind of Bond Endorsements Coupons Attached or Dates to Which Interest is Paid TOTAL VALUE American LegalNet, Inc. www.USCourtForms.com STOCKS Date of Issuance Exact Corporate Title Date of Maturity Number of Shares Interest Rate-% State of Incorporation TOTAL VALUE NOTES Date of Issuance By Whom Owing Date of Maturity Face Amount Interest Rate - % Date to Which Interes is Paid Unpaid Balance Endorse ments Description of Security TOTAL VALUE American LegalNet, Inc. www.USCourtForms.com MISCELLANEOUS INTERESTS AND ASSETS TOTAL VALUE SUITS PENDING Date Suit Instituted Person Against Whom Cause Exists Nature of the Suit Title of the Suit General Number Name of the Court Address of the Court ESTFdATED TOTAL VALUE Amount of Money on Hand, $ On Deposit in Bank, at $ On Deposit in Bank, at $ On Deposit in Bank, at $ TOTAL VALUE RECAPITULATION Real Estate $ Personal Property from Real Estate $ Bonds (approximate annual income $ Stocks $ Notes $ Miscellaneous Interest & Assets. $ Suits Pending (Estimate) Amount of Cash on Hand TOTAL ASSETS $ $ $ $ AFFIDAVIT (Name of Legal Representative) (Title) (Name of Legal Representative) (Title) on oath states that the foregoing inventory is complete and correct. Signed and sworn to before me , 20 (Legal Representative) (Notary Public) (Legal Representative) Name Attorney for Address City Telephone American LegalNet, Inc. www.USCourtForms.com -)