In The Circuit Court For The Seventh Judicial Circuit of Illinois Sangamon County, Springfield, Illinois ESTATE OF Case No. _ Deceased INVENTORY The following is the " inventory of the real and personal estate ofthe (decedent) (minor) (disabled person) that has come to the knowledge of the legal representative of this estate and of any case or action on which there is a right to sue: REAL ESTATE (legal description, improvements, encumbrances)*" Value -CO;:H~A=TT=E=L=--=P-=R-=O-=P=E=R=T=-yc-A:-:N-=D=-::C:-CA-=U-=S:::E:::S=-O=-F::--:A--=C=T=J=O=-N:-*=* ----------------,,-,V,--al=-u-e- PERSONAL ESTATE OTHER THAN CASH, GOODS AND CHATTELS (describe)'" Value NOTES"''' Value *Jnseli "amended" or "suppl ementa]" if applicable. *" Use Addenda if necessary. PR9101-19 American LegalNet, Inc. www.FormsWorkflow.com Amount of money on hand at date of death $, _ On deposit in at. $ _ On deposit in at $ _ On deposit in at $, _ The approximate value of personal estate at date of death $ The apprc>ximate annual income from real estate $, _ _ Legal Representative AFFIDAVIT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ on oath states that the above inventory is complete and correct. SUBSCRIBED AND SWORN to before me this day of _ 20__ Notary Pubhc - Clerk Name, _ Attorney for petitioner _ Address Telephone, _ American LegalNet, Inc. www.FormsWorkflow.com