State of Illinois

County of [County Name]

Introduction:

I, [YOUR NAME], being duly sworn, declare under penalty of perjury under the laws of the State of Illinois that the following is true and correct:

Statement of Facts:

1. The deceased, [Deceased’s Name], sadly passed away on [Date].

2. The death occurred in [City/County, State], marking a profound loss.

3. At the time of passing, [Deceased’s Name] was residing at [Deceased's Address], which served as their home.

4. This document serves to acknowledge the end of a life cherished by many and the beginning of the administrative process to honor [Deceased’s Name]'s legacy through the rightful distribution of their personal properties.

5. I am the [relationship to deceased] of the deceased and am qualified to make this affidavit. My relationship with the deceased provides me with personal knowledge of the facts stated herein.

6. The deceased owned the following described personal property at the time of death:

   • Vehicle: [Make, Model, Year, VIN]

   • Boat: [Make, Model, Year, Registration Number]

   • Motorcycle: [Make, Model, Year, VIN]

   • The total value of the described personal property does not exceed the amount prescribed by Illinois law for the small estate procedure.

7. The lawful heirs entitled to receive the property by virtue of a will or the laws of intestate succession are:

• [Heir’s Name], [Relationship to Deceased], [Address]

• [Heir’s Name], [Relationship to Deceased], [Address]

Purpose:

This affidavit is made for the purpose of requesting the transfer of the described personal property to the named heirs in accordance with Illinois law.

I declare under penalty of perjury under the laws of the State of Illinois that the foregoing is true and correct.

Executed this [Day] of [Month], [Year].

Signature:

[YOUR NAME]

Subscribed and sworn to before me this [Day] of [Month], [Year].

[NOTARY PUBLIC NAME]

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