IN THE CIRCUIT COURT FOR THE TWENTY-THIRD JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS IN THE MATTER OF THE ESTATE OF: __________________________________ Deceased CASE NO. ______________________________ DECEDENT'S PLACE OF RESIDENCE : City: County: State: Zip: DATE AND PLACE OF DEATH AND DATE OF WILL: Date of Death City & State Date of Will/Codicil Which Petitioner believes to be the valid last Will of the Decedent. ATTORNEY FOR PETITIONER: Name: Address: City & State: Telephone: Zip: _______________________________________ [] [] No tax will be due to the United States or this State by reason of the death of the decedent. All taxes due the United States or this State by reason of the death of the decedent have been paid or provided for. All taxes due the United States or this State by reason of the death of the decedent are the responsibility of another fiduciary. There is no unpaid claim. Attached is a list of all claimants known to petitioners and amount due each. PETITION FOR ADMISSION OF WILL AND SUMMARY ADMINISTRATION (not to exceed $50,000) The undersigned on oath states the decedent, whose name, residence at time of death are set forth herein, died leaving a will dated as shown. The gross value of the decedent's real and personal estate subject to administration in this State does not exceed $50,000 and is itemized on Exhibit A attached hereto and made a part of this petition. All heirs and legatees of the decedent have consented in writing to distribution of the estate on summary administration and their consents are attached to this petition. Each distribute tenders herewith a bond, with surety, in the value of this or her distributive share. Petitioner asks that the Will be admitted to probate, 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 heretofore issued, and discharge the representative. __________________________________________________ Petitioner __________________________________________________ Address Signed and sworn to before me this _______________ day of _________________________, 20 ___. __________________________________________________ Clerk of Court/Notary Public [] [] [] No person is entitled to a surviving spouse's or child's award. The following persons are entitled to a surviving spouse's and/or child's award and the minimum awards allowable and amounts heretofore paid are set forth below: Minimum Heretofore Name Age Award Paid [] [] ___________________________________ ______ Surviving Spouse ___________________________________ ______ _________________________________ Probate15\Petition for Admission of Will-Summary Administration 11/19/2012 American LegalNet, Inc. www.FormsWorkFlow.com $10,000 $2,000 $2,000 $_________________________ $_________________________ $_________________________ ______ Names of heirs, legatees and personal fiduciaries Relationship Right to nominate Preference "P" Equally "E" Heir � "H" Legatee "L" Personal Fiduciary "PF" Minor "M" Disabled Person "DP" Post Office Address (if "Unknown" so state) Probate14\Petition for Letters of Administration 11/19/2012 American LegalNet, Inc. www.FormsWorkFlow.com