3812 (Rev. 08/06) PETITION FOR LETTERS OF ADMINISTRATION (INTESTATE) - PROBATE STATE OF ILLINOIS UNITED STATES OF AMERICA IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT COUNTY OF DU PAGE IN RE THE ESTATE OF CASE NUMBER DECEASED File Stamp Here PETITION FOR LETTERS OF ADMINISTRATION * Independent Supervised The undersigned, on oath states: 1. The decedent , whose place of residence at the time of death was died on , at leaving no Will 2. The approximate value of the estate in this state is: Personal $ Real $ Annual Income From Real Estate $ 3. The name and addresses of the testator's heirs and legatees are (list heirs first): list on additional sheet Name Relationship Heir - H Legatee - L Minor - M Disabled - D Address (If unknown, so state) 4. The testator nominated the following to act in the office indicated above: Name Address 5. Petitioner is a of decendent and is legally qualified to act, or nominate a resident of Illinois to act. Petitioner asks that letters administration be issued. 6. * If so indicated above, the Petitioner requests independent administration. The name and address of the personal fiduciary designated to act during independent administration for each heir who is a minor or disabled person are shown on Exhibit A attached and made part of this petition. Petitioner Signature Name: PRO SE DuPage Attorney Number: Address , City, State, Zip Attorney for: Signed and sworn to before me Address: City/State/Zip: Date Telephone Number: If a counsul or consular agent is to be notified, name Country Circuit Clerk or Notary Public CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60189-0707 American LegalNet, Inc. www.FormsWorkflow.com