P ETITION FOR LE TTER S OF ADMINIS TRATION TO COLLE CT 3726(Rev. 07/05) UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT CASE NUM BER PLAINTIFF VS. DEFENDANT File Stamp Here PETITION FOR L ETTER S OF ADM INISTR ATION TO COL L ECT on oath states: 1. , whose place of residence at time of death was died (address) (city) (state) in (city and state) 2. Approximate value of the estate in this state: Personal $ Real $ Annual income from Real Estate$ 3. There will be delay in the issuance of letters testamentary or of administration because and the estate is liable to waste, loss or embezzlement unless an administrator to collect is appointed. 4. I am an interested person because I ask that letters of administration to collect issue to the following, qualified and willing to act: I ask that authorization to appraise goods and chattels issue to the following, qualified to act (an) (no) Name: PRO SE (Petitioner) DuPage Attorney Number: Address City Attorney for: Signed and sworn to before me Address: Date: City/State/Zip: [Circuit Court Clerk - Notary Public) Telephone: (Judge) CHR IS KACHIR OUBAS, CL ERK OF THE 18TH J UDICIAL CIRCUIT COURT American LegalNet, Inc. WHEATON, ILL INOIS 60189-0707 www.USCourtForms.com