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4159 Oath and Bond of Representative - Surety IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - PROBATE DIVISION Estate of

(Rev. 10/31/01) CCP 0312

_________________________________________________________

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No. _____________________________________ Docket _________________________________ Page __________________________________

OATH AND BOND OF REPRESENTATIVE - SURETY
I, ________________________________________, on oath state that I will faithfully discharge the duties of the office of representative. I and the undersigned sureties jointly and severally bind ourselves to the People of the State of Illinois to the faithful discharge of those duties. The obligation of this bond is limited to $ ____________________________. APPROVED: ______________________________________, ________ _______________________________________________
Judge Judge's No.

*_________________________________________________
as Representative and Principal

Address __________________________________________ __________________________________________________ *_________________________________________________
as surety

Address ___________________________________________ ________________________________________________ *_________________________________________________
as surety

Address ______________________________________________ _________________________________________________ Atty. No.: __________________ Name: __________________________________________ Firm Name: _______________________________________ Atty. for Representative: ___________________________ Address: _________________________________________ City/State/Zip:_________________________________ Telephone: _______________________________________
*First name of principal must be written in full.

Signed and sworn to before me by the representative on ________________________________________, _________ ___________________________________________________ (Clerk of Circuit Court) (Notary Public)

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