Free MATT MELUCCI - Illinois


File Size: 14.4 kB
Pages: 2
Date: June 27, 2008
File Format: PDF
State: Illinois
Category: Court Forms - Local
Author: eabechel
Word Count: 195 Words, 1,771 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.co.madison.il.us/CircuitClerk/PDF/NetProbateEstateClaimForm.pdf

Download MATT MELUCCI ( 14.4 kB)


Preview MATT MELUCCI
MATT MELUCCI CLERK OF THE CIRCUIT COURT THIRD JUDICIAL CIRCUIT

Filing Fees for Estate Claims 1. 2. 3. 4. When the amount of the claim is less than $150.00.............$0 When the amount claimed is $150.00 - $499.99.................$25.00 When the amount claimed is $500.00 - $9,999.99...............$40.00 When the amount claimed is in excess of $10,000.00..........$60.00

Please remit payment to:

Clerk of the Circuit Court 155 N. Main St., Suite 120 Attn: Probate Edwardsville, IL 62025

IN THE CIRCUIT COURT FOR THE THIRD JUDICIAL CIRCUIT MADISON COUNTY, ILLINOIS

Claimant:______________________ Address:_______________________ _______________________ In Re: The Estate of________________________, Deceased. Claim __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Case #____________ Amount of Claim ______________ ______________ ______________ ______________

______________________________, being duly sworn, on oath says that the Estate of:______________________________, deceased, is indebted to ______________________________________, in the sum of ______________. After allowing all just credits, deduction and set offs; that the same is just and unpaid on this _______ day of _________________, 20____. That attached hereto and made a part of this affidavit is a true and correct itemized statement of said account or a true and correct copy of original promissory note, showing all endorsements thereon.

________________________________ Claimant

Subscribed and sworn to before me this ________ day of ______________________, 20____.

____________________________________ (Seal) Notary Public - Clerk