In The Circuit Court For The Seventh Judicial Circuit of Illinois Sangamon County, Springfield, Illinois } IN THE ESTATE OF: Case Number: (Deceased) INVENTORY The following is the (amended)(supplemental) Inventory of the Real and Personal Estate of the (Circle One) (Decedent)(minor)(disabled person) that has come to the knowledge of the Legal Representative of this Estate (Circle One) and of any case or action on which there is a right to sue: REAL ESTATE (Legal Description, Improvements, Encumbrances)** Value CHATTEL PROPERTY AND CAUSES OF ACTION** Value PERSONAL ESTATE OTHER THAN CASH, GOODS AND CHATTELS (describe)** Value NOTES** Value **Use Addenda if necessary. Page 1 of 2 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 approximate Annual Income from Real Estate: $ Date Legal Representative AFFIDAVIT on oath states that the above Inventory is complete and correct. Affiant Subscribed and sworn to before me Notary Public/Clerk Name: Attorney s for: ARDC Number: Address: City: State: Zip: Area Code/Telephone: Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com