IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY 226 IN PROBATE Estate of CASE NO: FINAL REPORT OF INDEPENDENT REPRESENTATIVE independent representative of this estate, under penalties of perjury states that the administration of this estate has been completed and in accordance with s28-11 of the Probate Act of 1975 (755 ILCS 5/28-11) further states as follows: 1.Notice of probate has been given in compliance with Sec. 6-10 or Sec. 9-5 of the Probate Act.2.The notice to creditors required by Sec. 18-3 has been published, and the final publicationoccurred more than 6 months before the date of this report.3.Copies of the inventory and accounting having been mailed or delivered to the extent requiredby Sec. 28-6 and Sec. 28-11.4.Each claim filed has been allowed, disallowed, compromised, or dismissed, or is barred; and(a) * all claims allowed have been paid in full. (b) * the estate was not sufficient to pay all of the claims in full, and all claims allowed have been paid according to their respective priorities. 5.(a) * A spouse222s award has been .(paid) (waived) (is barred) (is not applicable) (b) * A child222s award has been . (paid) (is not applicable) 6.(a) * All death taxes have been determined and paid or otherwise provided for.(b) * The estate is not subject to death taxes.7.All administration expenses and other liabilities of the estate have been paid andadministration(a) * has been completed. (b) * has not been completed but has been provided for (see attached). 8.Notice of probate and release of the estate222s interest in real estate has been recorded to theextent required by law.9.The remaining assets of the estate have been distributed to the persons entitled thereto.(SEE REVERSE SIDE) 37 C (Revised 1/6) American LegalNet, Inc. www.FormsWorkFlow.com 10.The fees paid or payable to the independent representative and attorney approved by all interested persons.(have been) (have not been) 11.Receipts have been obtained from all heirs or legatees and written approvals obtained fromunpaid creditors and are filed with this report, except (see attached). Independent Representative , 20 Attorney Certification Atty. Name ARDC # Firm Name Attorney for Address City & Zip Telephone , CLERK OF THE CIRCUIT COURT 37 C (Revised 1/6) American LegalNet, Inc. www.FormsWorkFlow.com