Fillable Small Estate Affidavit Form (Page 3 of 4) in pdf

Small Estate Affidavit Form Page 3

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Class 7: All other claims, as follows:

Name and Post Office Address

Amount

7.5

I understand that all valid claims against the decedent's estate described in Paragraph 7 must be paid by me from the

decedent's estate before any distribution is made to any heir or legatee. I further understand that the decedent's estate should

pay all claims in the order set forth above, and is the decedent's estate is insufficient to pay the claims in any one class, the

claims in that class shall be paid pro rata.

There is no known unpaid claimant or contested claim against the decedent, except as stated in paragraph 7.

9. (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

*(Note: An adult dependent child is one who is unable to maintain himself and is likely to become a public charge.)

(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 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), to be divided

among them in equal shares.

10. (a) The decedent left no will. The names, places of residence and relationship 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

(or)

(b)

The decedent left a 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 admissible 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).)

Small Estate Affidavit Form Page 3

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