q 0014 q 1014 Jury Petition For Summary Administration (Intestate) (03/18/16) CCP N500 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, PROBATE DIVISION Estate of ___________________________________________________ Deceased Case No. _____________________________________ PETITION FOR SUMMARY ADMINISTRATION (INTESTATE) ______________________________________________________________________________ on oath states: 1. _______________________________________________ , whose place of residence at the time of death was ______________________________________________________________________________________ , died ______________ at _____________________________________________________ , leaving no will. (date) (city) (state) (zip code) (address) (city) (county) (state) (zip) 2. The gross value of the decedent's real and personal estate subject to administration in this State does not exceed $50,000.00 and is itemized on Exhibit A attached and made a part of this petition. *3. (a) There are no unpaid claims against the estate. (b) The unpaid claims against the estate are itemized on Exhibit A attached and made a part of this petition. *4. (a) No tax will be due to the United States or this State by reason of the death of the decedent. (b) All taxes due to the United States or this State by reason of the death of the decedent have been paid or provided for. (c) All taxes due to the United States or this State by reason of the death of the decedent are the responsibility of another fiduciary. ______________________________________________________________________ (Insert name and address) *5. (a) No person is entitled to surviving spouse's or child's award. (b) The persons entitled to a surviving spouse's award and the minimum awards allowable and amounts paid are set forth on Exhibit A attached hereto and made a part of this petition. 6. The name and post-office addresses of decedent's heirs are set forth on Exhibit A attached hereto and made a part of this petition.(Indicate the relationship and whether an heir is a minor or disabled person.) 3004 7. All heirs of the decedent have consented in writing to distribution of the estate on summary administration and their consents are attached to this petition. 8. Each distributee tenders herewith a bond, with surety, in the value of his or her distributive share. Petitioner asks that the court determine the rights of claimants and other persons interested in the estate, direct payment of claims and distribution of the estate on summary administration, excuse the issuance of letters of office or revoke the letters issued, and discharge the representative. Atty. No.: __________________ Atty. Name: _________________________________ Atty. for: ___________________________________ Address: ____________________________________ City/State/Zip: _______________________________ Telephone: __________________________________ Primary Email: _______________________________ Secondary Email: _____________________________ Tertiary Email: ______________________________ *Strike (a),(b), or (c) if not applicable. ___________________________________________ Petitioner Address: ____________________________________ City/State/Zip: _______________________________ Primary Email: _______________________________ Signed and sworn before me ___________________________________________ ___________________________________________ Notary Public DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com