IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS ESTATE OF ) ) ) ) _____________________________________________ ) a minor ) Case No. ________________________ ACCEPTANCE AND OATH OF OFFICE I, _______________________________________________, under penalties of perjury as provided by law (Name of Court-appointed Guardian) hereby state that I accept the office of guardian of the person estate for _________________________________ (Name of Minor) the above named minor; and further state that I will discharge faithfully the duties of said office. CERTIFICATION Under penalties of perjury as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct. Date: ______________________, 20____. ___________________________________________ Signature of Court-appointed Guardian ___________________________________________ Printed Name of Court-appointed Guardian Prepared by: Name: ____________________________________________ Attorney's Name: ____________________________________ Address: __________________________________________ City: ______________________________ State: __________ Phone: ______________________Zip Code: _____________ Fax: ______________________________________________ ARDC #: __________________________________________ 171P-28 (Rev. 12/11) American LegalNet, Inc. www.FormsWorkFlow.com