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Estate Claim - Illinois

Estate Claim Form. This is a Illinois form and can be used in Civil Madison Local County .
 Fillable pdf Last Modified 12/27/2010
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IN THE CIRCUIT COURT FOR THE THIRD JUDICIAL CIRCUIT MADISON COUNTY, ILLINOIS Claimant:______________________ Address:_______________________ _______________________ In Re: The Estate of________________________, Deceased. Claim __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Case #____________ Amount of Claim ______________ ______________ ______________ ______________ ______________________________, being duly sworn, on oath says that the Estate of:______________________________, deceased, is indebted to ______________________________________, in the sum of ______________. After allowing all just credits, deduction and set offs; that the same is just and unpaid on this _______ day of _________________, 20____. That attached hereto and made a part of this affidavit is a true and correct itemized statement of said account or a true and correct copy of original promissory note, showing all endorsements thereon. ________________________________ Claimant Subscribed and sworn to before me this ________ day of ______________________, 20____. ____________________________________ (Seal) Notary Public - Clerk American LegalNet, Inc. www.FormsWorkFlow.com
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