Introduction

This Small Estate Affidavit is issued by the [COUNTY NAME] Probate Court of the State of Illinois to inform the beneficiaries of the estate of [DECEDENT'S NAME] about the assets left behind by the deceased individual.

We, the undersigned, declare the following information regarding the estate of the deceased individual:

Statement of Facts

1. Personal Information of Deceased Person:

   • Full Name: [DECEDENT'S NAME]

   • Date of Birth: [DECEDENT'S BIRTH DATE]

   • Date of Death: [DECEDENT'S DEATH DATE]

2. Assets Left Behind:

   • We have determined that the deceased individual left behind the following assets:

     • Bank accounts

     • Household furniture and appliances

     • Residential property located at [PROPERTY ADDRESS]

3. Total Value of Assets:

   • Based on our assessment, the total estimated value of the assets left behind by the deceased individual is $[AMOUNT] (excluding the value of real estate).

4. Beneficiaries/Heirs:

   • The beneficiaries/heirs entitled to the assets of the estate are:

     • [BENEFICIARY'S NAME]

5. Purpose of Affidavit:

   • This Small Estate Affidavit is issued to facilitate the transfer of assets to the rightful beneficiaries without the need for a formal probate proceeding, as the total value of the estate falls below the threshold specified by Illinois state law.

6. Verification:

   • We, the undersigned, hereby declare under penalty of perjury that the information provided in this affidavit is true and accurate to the best of our knowledge and belief.

Signature

[YOUR NAME]

For any inquiries or further assistance regarding the estate of [DECEDENT'S NAME], please contact the [COUNTY NAME] Probate Court using the contact information provided above.

Sincerely,

[CLERK'S NAME]

Clerk

[PROBATE COURT NAME]

[DATE]

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