Fillable Small Estate Affidavit (Page 3 of 3) in pdf

(d)

Affiant is unaware of any dispute or potential conflict as to the hiership or will of decedent.

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.

Subscribed and sworn before me this

_____ day of _______________, ________.

____________________________________

Signature of Affiant

___________________________________

Notary Public

Clerk

Prepared by: ___________________________________________________________________________

(a)

Appointment of Agent. If safe deposit access is involved or if sale of any personal property is desirable to

facilitate distribution pursuant to the small estate affidavit, all persons name in paragraph 10 of the small estate

affidavit (excluding minors and unascertained or disabled persons) may in writing appoint one or more persons

as their agent for that purpose. The agent shall have power, without court approval, to gain access to sell, and

distribute the property for the benefit of all persons named in paragraph 10 of the affidavit; and the payment,

delivery, transfer, access or issuance shall be made or granted to or on the order of the agent.

(b)

Release. Upon payment, delivery, transfer, access or issuance pursuant to a properly executed affidavit, the

person or corporation is released to the same extent as if the payment, delivery, transfer, access or issuance had

been made or granted to the representative of the estate. Such person or corporation is not required to see the

application of disposition of the property; but each person to whom a payment, delivery, transfer, access or

issuance is made or given is answerable therefor to any person having a prior right and is accountable to any

representative of the estate.

(c)

The affiant signing the small estate affidavit prepared pursuant to subsection (b) of the Section shall indemnify

and hold harmless all creditors and heirs of the decedent and other persons relying upon the affidavit who incur

loss because of such reliance. Such indemnification shall only be up to the amount lost because of the act or

omission of the affiant. Any person recovering under this subsection shall be entitled to reasonable attorney’s

fees and the expenses of recovery.

(d)

The affiant of a small estate affidavit who is a non-resident of Illinois submits himself or herself to the

jurisdiction of Illinois courts for all matters related to the preparation or use of the affidavit. The affidavit shall

provide the name, address, and phone number of a person whom the affiant names as his agent for service of

process. If no such person is named or if, for any reason, service on the named person cannot be effectuated,

the attorney who prepared the affidavit shall be the agent for service of process.

171P-1 Rev.12/10

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