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Chart Of Heirship And Affidavit Of Heirship Form. This is a Illinois form and can be use in Lake Local County.
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Tags: Chart Of Heirship And Affidavit Of Heirship, 171P-25, Illinois Local County, Lake
NOTE: A completed affidavit of heirship must be prepared by the responsible attorney or party. This form is
provided only as a guide and aid in the preparation of that affidavit.
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
Estate of
)
)
)
)
)
Deceased.
No.
CHART OF HEIRSHIP
for ________________________________________, deceased
(to be completed to the extent applicable)
____________________________________
Decedent
_________________________________
Spouse
children: ___________________________________________,
__________________________________________,
___________________________________________,
__________________________________________,
grandchildren: ______________________________________,
__________________________________________,
_____________________________________ ,
__________________________________________,
(children of predeceased child)
great-grandchildren __________________________________,
__________________________________,
__________________________________________,
__________________________________________,
(children of predeceased grandchild)
171P-25 Rev 09/00
2002 © American LegalNet, Inc.
IN THE CIRCUIT COURT OF THE NINETEENTH
JUDICIAL CIRCUIT, LAKE COUNTY, ILLINOIS
Estate of
Deceased.
)
)
)
)
)
No.
PROBATE DIVISION
AFFIDAVIT OF HEIRSHIP
_________________________________________________________, under the penalties of perjury states:
(affiant’s name)
1. The Decedent, _____________________________________, died at ________________________, Illinois
on _________________________, at the age of ________ years, who had __________ children born or adopted.
(date)
(number)
2. I am of legal age. I am ___________________________________________ of the Decedent. I reside at
(State relation to Decedent)
______________________________________________________________, Illinois.
3. Decedent was married to____________________________________________________,
(a) who is living, and is Decedent’s surviving spouse.
(b) which marriage ended in divorce.
(c) who pre-deceased decedent.
______________ children were born or adopted of said marriage.
(no. of children)
4. Information of living children:
Name
Age
Other Parent’s
Name
Address
________________________
_______
_____________________________________________ ________________
________________________
_______
_____________________________________________ ________________
________________________
_______
_____________________________________________ ________________
________________________
_______
_____________________________________________ ________________
5. Information of pre-deceased children:
Age at
Death
Name
No. of children born or
adopted of said Child
Other Parent’s
Name
________________________
_______
_____________________________________________ ________________
________________________
_______
_____________________________________________ ________________
6. Children born or adopted of a deceased child:
Grandchild’s Name
Age
Parent’s Name
(Decedent’s Child)
Address
_______________________
_______
_____________________________________________ ________________
_______________________
_______
_____________________________________________ ________________
7. Complete this section if Decent died without surviving spouse or living decedents.
Parents
The Decedent’s mother was ________________________________, who __________________________ the Decedent.
(survived) (pre-deceased)
The Decedent’s father was_________________________________, who __________________________ the Decedent.
(survived) (pre-deceased)
171P-26 Rev 09/00
Page 1 of 2
2002 © American LegalNet, Inc.
Brothers and Sisters
The Decedent had the following brothers and sisters:
Name
Age
Survived-S
Pre-Deceased-P
Address
No. of
Children
_______________________
______
______________________________________________
________ _______
_______________________
______
______________________________________________
________ _______
Children of a Deceased Sibling
The Decedent had the following nieces and nephews born or adopted of a deceased sibling.
Name
Age
Survived-S
Parent’s name
Pre-Deceased-P (Decedent’s Sibling)
Address
________________________ ______
_________________________________________ ________ ____________
________________________ ______
_________________________________________ ________ ____________
8. Other information as to heirs, if needed:
Name
Age
Relationship
Address
Parent’s Name
________________________ ______
___________
_____________________________________ ____________
________________________ ______
___________
_____________________________________ ____________
9. Except as otherwise herein specifically mentioned and set forth, there were no adoptions and no child(ren) born
out of wedlock known to Affiant.
10. Based on the foregoing, Decedent left surviving, as Decedent’s only Heirs, the following, all of whom survived
Decedent, and, in the absence of an indication to the contrary, are of legal age and mentally competent:
(Disabled-D; Minor-M)
Name
Relationship
Name
Relationship
_____________________________, ________________;
______________________________, _____________;
_____________________________, ________________;
______________________________, _____________;
_____________________________, ________________;
______________________________, _____________;
_____________________________, ________________;
______________________________, _____________;
THE UNDERSIGNED states under oath that the above is true and accurate to the best of his/her knowledge.
____________________________________
Affiant
Name
Attorney for
Subscribed and sworn to before me this
Address
______ day of ___________________, _____
City & Zip
Telephone
____________________________________
Notary Public
171P-26 Rev 09/00
Page 2 of 2
