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Petition For Letters Of Administration

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     0004 Supervised      1004 Jury      0005 Independent      1005 Jury

Petition For Letters Of Administration

(Rev. 09/06/13) CCP 0302

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

Estate of

No. _________________________________________

_____________________________________________

Deceased

PETITION FOR LETTERS OF ADMINISTRATION

_______________________________________________________

, states under the penalties of perjury:

_______________________________________________

, whose place of residence at the time of death was

________________________________________________________________________________

(address)

(city)

(county)

(state)

(zip)

____________________

_______

______________________________________

died

, at

leaving no will.

(city)

(state)

The approximate value of the estate in this state is:

Annual Income

Personal

Real

From Real Estate

______________________

The names and post-office addresses of decedent's heirs are set forth on Exhibit A and made a part of this petition.

(Indicate the relationship and whether an heir is a minor or disabled person.)

The names and post-office addresses of persons who are entitled to nominate and/or administer in preference to

(P) or equally with (E) petitioner are set forth on Exhibit A of this petition. If none, so state:

__________________________________

_______________________________

Petitioner is a

of decedent and is legally qualified to act (or to nominate

a resident of Illinois to act) as administrator.

*6 The name and post-office address of the personal fiduciary designated to act during independent administration

for each heir, who is a minor or disabled person, are shown on Exhibit A of this petition.

Petitioner asks that Letters of Administration issue to the following person(s), qualified and willing to act:

Name

Post-Office Address

____________________________________

_______________

Atty. No.

Petitioner

_____________________________________

Atty. Name:

_____________________________

Address:

____________________________________

Firm Name:

_________________________

City/State/Zip:

_______________________________________

Address:

___________________________________

City/State/Zip:

___________________________

Telephone:

______________________________________

Telephone:

______________________

Atty. Certification

_______________________________

If a consul or consular agent is to be notified, name country:

*If supervised administation is requested, so state and strike Paragraph 6.

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

Petition For Letters Of Administration

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