81-803 Petition for Summary Administration (Intestate) UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DUPAGE I N THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT No. Estate of Deceased File Stamp Here PETITION FOR SUMMARY ADMINISTRATION (INTESTATE) on oath states; 1. , whose place of residence of the time of death was (address) (city) (state) (county) 19 died , at , leaving no will. (city) (state) 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 itemized on Exhibit A attached hereto and made a part of this petition. 3. There are no unpaid claims against the estate except the following: (if none, so indicate.) Name Amount Address $ $ $ *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 the United States or this State by reason of the death of the decedent have been paid or provided for. (c) All taxes due 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 entitled to a surviving spouse's or child's award (b) The following persons are entitled to a surviving spouse's or child's award and the minimum awards allowable and amounts heretofore paid are as follows: Minimum Age Name Award $5,000.00 $ $1,000.00 6. $ $1,000.00 (Surviving Spouse) Heretofore Paid $ The names and post-office address of the decedent's heirs are: Name Relationship Post-office address (If unknown, so state.) Minor-M Disabled Person - D 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. Petitioners 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 heretofore issued and discharge the representative. Name Petitioner Attorney for the Petitioner Address DuPage Attorney No. City Address Signed and sworn to before me City , 19 Phone *Strike (a), (b) or (c) if not applicable. Notary Public CHRIS KACHIROUBAS, CLERK OF THE 18TH JUDICIAL CIRCUIT COURT WHEATON, ILLINOIS 60189-0707 © American LegalNet, Inc. www.FormsWorkflow.com