STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 20TH JUDICIAL CIRUCIT ST. CLAIR COUNTY, ILLINOIS- IN PROBATE In the Matter of the Estate of ______________________________ Deceased ) ) ) ) ) ) ) ) ) ) Case No.:______________________ Hearing on petition set for ________ _____________________, 20_____. __________a.m./p.m., Room______ County Courthouse Belleville, Illinois ____________________________ (Judge) PETITION FOR LETTERS OF ADMINISTRATION __________________________________________________________________on oath states: 1. _____________________________, whose place of residence at the time of death was ______________________________________________________________________________ (Address ) (City) ________________________________________________________ (County) (State) died_______________________, 20_____, at _________________________________________________________, leaving no will. (City) (State) 2. Approximate value of the estate in this state: Personal $__________ Real $____________ Annual income from real estate$_________ 3. The names and post office addresses of the decedent’s heirs are: Names Relationship Minor- M Disabled Person- D Post Office Address (if known, so state) 4. The names and post-office address of persons who are entitled to nominate an administrator in preference to (P) or equally with (E) petitioner are (if none, so state): Names Relationship P or E Post Office Address (if known, so state) 1 American LegalNet, Inc. www.FormsWorkflow.com 5. Petitioner is a __________________________________of the decedent and is legally qualified to act, or to nominate a resident of Illinois to act, as administrator. Petitioner asks that letters of administration issue to the following, qualified and willing to act: Name Post-Office Address *6. The gross value as of the date of death of the decedent’s real and personal estate subject to administration in Illinois does not exceed $150,000. Petitioner request independent administration. The name and post office address of the personal fiduciary designated to act during independent administration for each heir who is a minor or disable person are shown on Exhibit A attached hereto and made a part of this petition. ____________________________________ Petitioner Address____________________________ City________________________________ Signed and sworn to before me _____________________________, 20____ ____________________________________ Notary Public Name Attorney for Petitioner Address City Telephone If a consul or consular agent is to be notified, name country:_____________________________ * Strike if not applicable. 2 American LegalNet, Inc. www.FormsWorkflow.com