STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE SEVENTH JUDICIAL CIRCUIT SANGAMON COUNTY - IN PROBATE In the Matter of the Estate of ________________________________ Deceased } Case No.:____________ Hearing on petition set for _________________________________ ____________ ____.m., Room_______ County Courthouse _____________________, Illinois _________________________________ (Judge) PETITION FOR ADMISSION OF WILL AND SUMMARY ADMINISTRATION _______________________________________________________________________________________________ on oath states: 1. _____________________________________________________________________________________, whose place of residence at the time of death was ________________________________________________________________________________ (address) ____________________________________________________________________________________________________________ (city) (county) (state) died _________________________________________________, at ___________________________________________________ (city) (state) leaving a will dated _______________________________________________, __________________________________________, (and codicil dated____________________) which petitioner believes to be the valid last will and testator. 2. The gross value of the decedent's real and personal estate subject to administration in this State does not exceed $50,000 and is 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 Address ___________________________________________________________________________ Amount $___________________________ ___________________________________________________________________________ $___________________________ ___________________________________________________________________________ $___________________________ *4. (a) No taxes will be due to the United States or to this State by reason of the death of the decedent. (b) All taxes due to the United States or to this State by reason of the death of the decedent have been paid or provided for. (c) All taxes due to the United States or to this State by reason of the death of the decedent are the obligation of another fiduciary, ____________________________________________________________________________________________________ (name and address) American LegalNet, Inc. www.USCourtForms.com *5. (a) No person is 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: Age Minimum award _______ $5,000 $___________________________ __________________________ _______ $1,000 ___________________________ __________________________ _______ $1,000 ___________________________ Name __________________________ Heretofore paid (surviving spouse) 6. The names and post-office addresses of the decedent's heirs are (List heirs first): Name Relationship Heir-H Legatee-L Minor-M Disabled Person-D Post-office address (if unknown, so state) 7. All heirs and legatees of the decedent have consented in writing to distribution of the estate on summary administration, and their consents are attached to this petition. 8. The bond of each distributee, with surety, in value of his or her distributive share is tendered herewith. Petitioner 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 and (Check one) _____ (a) excuse the issuance of letters of office _____ (b) revoke the letters heretofore issued and discharge the representative ___________________________________________ Petitioner Attorney:_______________________________________ Address:_______________________________________________ Address____________________________________ City_______________________________________ City:___________________________________________ Signed and sworn to before me __________________________________, 20_____ Telephone_(____)________________________________ __________________________________________ Notary Public *Strike (a), (b), or (c) if not applicable. American LegalNet, Inc. www.USCourtForms.com