STATE OF ILLINOIS) )SS COUNTY OF WILL ) IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS - IN PROBATE Estate of CASE NO:______________________ CLAIM 1. Claimant (name) against this estate. has a claim for $ 2. The nature of the claim is* Address City and State Telephone Attorney Name_____________________________________ ARDC#___________________________________________ Firm Name________________________________________ Attorney for Petitioner_______________________________ Address___________________________________________ City & Zip_________________________________________ Telephone_________________________________________ *When the claim is based upon a written instrument, a copy of the instrument must be attached. When the claim is based on tort, so state. (SEE REVERSE SIDE) PAMELA J. MCGUIRE, CLERK OF THE CIRCUIT COURT OF WILL COUNTY 2000 © American LegalNet, Inc. No.___________________________ _________________, 20___ , 20 IN THE CIRCUIT COURT OF WILL COUNTY County Department - Mailing and delivery of copy of claim waived _________________________________________ (Representative) (Attorney for Representative) Probate Division _________________,20 Estate of I (certify) (state of oath) that on , 20 a copy of this claim was (mailed) (delivered in person) (mailed by ordinary mail) to Representative and to Attorney for Representative CLAIM Attorney or Agent for claimant (Agent's statement must be notarized) Subscribed and sworn to before me this , 20 . Claimant Amount of Claim $ day of Notary Public Set for hearing at , 20 , 20 m. in Room I consent to the allowance of this claim for $ as a claim of the class. Representative Attorney for Representative WILL COUNTY COURTHOUSE JOLIET, ILLINOIS 60431 PAMELA J. McGUIRE, CLERK OF THE CIRCUIT COURT OF WILL COUNTY Date of Letters , 20 Unless the representative or his attorney waives in writing the mailing or delivery of a copy of the claim or consents in writing to the allowance of the claim, the claimant shall cause a copy of the claim to be mailed or delivered to the representative and to his attorney of record, if any, and shall file proof of such mailing or delivery within 10 days after the filing of the claim. 2000 © American LegalNet, Inc.