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2616 Proof Of Mailing And Publication IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - PROBATE DIVISION Estate of _____________________________________________________ Deceased

(Rev. 7/7/00) CCP 1000 A

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No. ___________________________________ Docket _______________________________ Page _________________________________

PROOF OF MAILING AND PUBLICATION The undersigned states under the penalties of perjury: 1. On __________________________________, ________, the following required notices* were mailed to each person whose name and address are stated on the reverse side: (Please list notices mailed.) ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ _________________________________________________________________________________________________________ __________________________________________________________________________________________________ Copies of each notice and the required documents, as mailed, are in the possession of the attorney. 2. The following notices * have been published:

_________________________________________________________________________________________________ ___________________________________________________________________________________________________ The publisher's certificate for each notice is attached hereto or is on file with the clerk of the court.

Atty. No.:__________________

_______________________________________________ Petitioner/Representative/Attorney Name: ________________________________________________ Firm Name: __________________________________________ Atty. for Representative: _____________________________ _____________________________________, ________ Date Address: _____________________________________________ City/State/Zip: _________________________________________ Telephone: ___________________________________________ __________________________________________________ Attorney Certification if signed by Petitioner or Representative (Sup. Ct. Rule 137) (*SEE REVERSE SIDE) DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

(Rev. 7/7/00) CCP 1000 B *Fill in the blanks in 1 and 2 with the appropriate notices under the Probate Act. The more frequently used forms are listed below: PROBATE ACT § Form # 1020 Form # 1003 A-B Form # 1004 Form # 1007 Form # 1008 (A) (B) (C) (D) (E) 6-10 28-2 9-5 and 6-2 28-4(a) 28-11(e) 18-3 6-10 and 18-3 9-5 and 18-3 28-11 (e) 9-8(g) DESCRIPTION OF NOTICE Mailed Notices Notice to heirs and legatees -- will admitted Notice to heirs and legatees of rights in independent administration Notice to heirs of hearing on petition for letter of administration (or L/A with will annexed) Notice of termination of independent administration Notice of final report-- independent administration Published Notices Claims notice Notice to unknown heirs and legatees of admission of will, and claims notice Grant of independent administration in intestacy and claims notice Final report filed -- independent administration Summary administration notice

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