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Small Estate Affidavit - Illinois

Small Estate Affidavit Form. This is a Illinois form and can be used in Probate Kankakee Local County .
 Fillable pdf Last Modified 7/9/2014
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STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE TWENTY-FIRST JUDICIAL CIRCUIT KANKAKEE COUNTY ­ IN PROBATE SMALL ESTATE AFFIDAVIT I, ____________________________________________________, on oath state: 1. (a) My post office address is ___________________________________________________________________________; (b) My residence address is _________________________________________________________________________; and (c) I understand that, if I am an out-of-state resident, I submit myself to the jurisdiction of Illinois courts for all matters related to the preparation and use of this affidavit. My agent for service of process in Illinois is: NAME _______________________________________________________________________________ ADDRESS ____________________________________________________________________________ CITY ________________________________________________________________________________ TELEPHONE (if any) ___________________________________________________________________ I understand that if no person is named above as my agent for service, or, if for any reason, service on the named person cannot be effectuated, the attorney who prepared this affidavit on my behalf is recognized by Illinois law as my agent for service of process. 2. 3. The decedent's name is ________________________________________________________________________ ; The date of the decedent's death was _____________________________________________________________ , And I have attached a copy of the death certificate hereto; 4. 5. The decedent's place of residence immediately before his death was _____________________________________ ; No letters of office are now outstanding on the decedent's estate and no petition for letters is contemplated or pending in Illinois or in any other jurisdiction, to my knowledge; 6. The gross value of the decedent's entire personal estate, including the value of all property passing to any party either by intestacy or under a will, does not exceed $100,000.00. (Here, list each asset, e.g., cash, stock and its fair market value,); 7. (a) All of the decedent's funeral expenses have been paid, or (b) The amount of the decedent's unpaid funeral expenses and the name and post office address of each person entitled thereto are as follows: Name and post office address: __________________________________________________________________ Amount $ ________________ (Strike either 7(a) or 7(b).) 8. 9. (a) There is no known unpaid claimant or contested claim against the decedent, except as stated in paragraph 7; (a) The names and places of residence of any surviving spouse, minor children and adult dependent* children of the decedent are as follows: Name and relationship Place of residence Age of minor child * (Note, an adult dependent child is one who is unable to maintain himself and is likely to become a public charge.) American LegalNet, Inc. www.FormsWorkFlow.com (b) The award allowable to the surviving spouse of a decedent who was an Illinois resident is $_______________($20,000, plus $10,000 multiplied by the number of minor children and adult dependent children who resided with the surviving spouse at the time of the decedent's death. If any such child did not reside with the surviving spouse at the time of the decedent's death, so indicate.) (c) If there is no surviving spouse, the award allowable to the minor children and adult dependent children of a decedent who was an Illinois resident is $_______________ ($20,000, plus $10,000 multiplied by the number of minor children and adult dependent children), to be divided among them in equal shares. 10. (a) The decedent left no will. The names, places of residence and relationships of the decedent's heirs, and the portion of the estate to which each heir is entitled under the law where decedent died intestate are as follows: Name, relationship, and place of residence Age of minor Portion of estate (b) The decedent left no will, which has been filed with the clerk of an appropriate court. A certified copy of the will on file is attached. To the best of my knowledge and belief, the will on file is the decedent's last will and was signed by the decedent and the attesting witnesses as required by law and would be admittable to probate. The names and places of residence of the legatees and the portion of the estate, if any, to which each legatee is entitled are as follows: Name, relationship, and place of residence Age of minor Portion of estate (Strike either 10(a) or 10(b).) 11. The property described in paragraph 6 of this affidavit should be distributed as follows: Name Specific sum or property to be distributed The foregoing statement is made under the penalties of perjury*. __________________________________________________ Signature of Affiant *(Note: A fraudulent statement made under the penalties of perjury is perjury, as defined in Section 32-2 of the Criminal Code of 1961.) I, ______________________________________________________, am an attorney, duly licensed to practice law in the State of Illinois. I have prepared the foregoing affidavit on behalf of the party signing it. Further, based upon the information supplied to me, which I have no reason to believe is not true and accurate, paragraphs 9 through 11 correctly reflect the appropriate heirship and distributions under the applicable law and any will. NAME _______________________________________________________________________________ ADDRESS ____________________________________________________________________________ CITY ________________________________________________________________________________ BUSINESS TELEPHONE NUMBER _______________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com
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