PETITION FOR LETTERS OF ADMINISTRATION (INTESTATE) - PROBATE STATE OF ILLINOIS UNITED STATES OF AMERICA IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT 3812 (Rev. 08/06) COUNTY OF DU PAGE IN RE THE ESTATE OF CASE NUMBER DECEASED File Stamp Here PETITION FOR LETTERS OF ADMINISTRATION * Independent The undersigned, on oath states: 1. The decedent , whose place of residence at the time of death was Supervised died on , at leaving no Will 2. The approximate value of the estate in this state is: Personal $ Name Real $ Relationship Heir - H Legatee - L Annual Income From Real Estate $ Minor - M Disabled - D Address (If unknown, so state) 3. The name and addresses of the testator's heirs and legatees are (list heirs first): list on additional sheet 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: DuPage Attorney Number: Attorney for: Address: City/State/Zip: Telephone Number: PRO SE Address , City, State, Zip Signed and sworn to before me Date Circuit Clerk or Notary Public American LegalNet, Inc. www.FormsWorkflow.com If a counsul or consular agent is to be notified, name Country CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT � WHEATON, ILLINOIS 60189-0707