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755 ILCS 5/25-1(755 ILCS 5/25-1) (from chap. 110 1/2, par. 25-1)
Sek. 25-1.Payment or delivery of the small estate of the deceased against affidavit.
(a) When an individual, company or financial institution (1) owes or disposes of personal estate to a deceased person, (2) controls the right of access to the deceased person's safe deposit box, or (3) acts as a registrar or transfer agent for any proof of interest If a debt, property or right is accompanied by an affidavit of small estate in substantially the form set forth below, that person, business or financial institution must pay the debt, provide access to the safe deposit box, deliver the personal estate or transfer or issue the proof of interest, debt, property or right to any person and in the manner specified in the affidavit or to an appointed agent as described below.
(B)Affidavit for small estates
I,(Name des Affianten), under oath:
1.(a) My postal address is:;
(b) My residential address is:; And
(c) I understand that if I reside outside of a state, I submit to the jurisdiction of the courts of Illinois in all matters relating to the preparation and use of this affidavit. My attorney in Illinois is:
NAME..........................
ADDRESS.......................
CITY..........................
TELEPHONE (IF PRESENT).............
I understand that if no person is named above as my agent for service of process, or if service on the person named cannot be effected for any reason, the clerk of the District Court of ......(county) (Judicial Circuit) Illinois will have jurisdiction recognized by Illinois law as my counsel.
2. The name of the deceased is;
3. The date of death of the deceased was, and I have attached a copy of the death certificate here.
4. The domicile of the deceased immediately before his death;
5. There are no writs outstanding in the estate of the deceased at this time, and to my knowledge no writs are pending or pending in Illinois or any other jurisdiction;
6. The gross value of the entire personal estate of the deceased, including the value of all assets passed to either party by testament or will, does not exceed US$100,000. (List each asset here, e.g. cash, stocks, and its fair market value.);
7. (a) All funeral expenses and other debts of the deceased have been paid, or
(b) All known unpaid debts of the deceased are listed and classified (including name, postal address and amount) as follows:
Class 1: Funeral and burial expenses, inclusive
| | reasonable amounts paid for a tomb, crypt, or alcove; a marker on the grave site; and maintenance of the burial space, crypt or niche; Administrative expenses; and statutory custody claims as follows:
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Class 2: Surviving Spouse or Child Award,
| | ..........................................................
Class 3: Debts to the United States as follows:
..........................................................
Class 4: Amounts no longer due to employees of the deceased
| | as $800 to each claimant for services rendered within 4 months prior to the death of the deceased and for expenses related to the most recent medical condition, as follows:
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| ..........................................................
Class 5: Money and property received by or held in trust by
| | the deceased who cannot be identified or traced as follows:
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Class 6: Debts of the State of Illinois and any county,
| | Illinois borough, city, village or school district as follows:
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| ..........................................................
Class 7: all other claims as follows:
..........................................................
(Delete either 7(a) or 7(b)).
7.5. I understand that I must settle all valid claims against the deceased's estate described in paragraph 7 out of the deceased's estate before any distribution to an heir or legatee is made. I further understand that the deceased's estate should settle all claims in the order set out above, and if the deceased's estate is insufficient to settle the claims of any class, the claims of that class will be settled pro rata.
8. Except as provided in paragraph 7, there is no known unpaid claimant or contested claim against the deceased.
9. (a) The names and addresses of all surviving spouses, minor children and adult dependent* children of the deceased are as follows:
| name and | place of | Age of | Relationship | Residence | minor child |
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*(Note: an adult dependent child is a child who is unable to support themselves and is likely to become a public duty.)
(b) The indemnity due to the surviving spouse of a deceased who was an Illinois resident is $20,000 plus $10,000 multiplied by the number of dependent children, minor and adult, who lived with the surviving spouse at the time of the decedent's death . If such a child was not living with the surviving spouse at the time of the deceased's death, please indicate so.
(c) If there is no surviving spouse, the award for the minor children and adult dependent children of a deceased Illinois resident is $20,000 plus $10,000 multiplied by the number of minor children and adult dependent children ), which will be divided equally among them.
10. (a) The deceased left no will. The names, places of residence and family relationships of the heirs of the deceased, and the portion of the estate to which each heir is entitled under the law in which the deceased died intestate, are as follows:
| name, relationship | Age of | part of | and place of residence | irrelevant | estate |
| OR | |
| (b) the deceased left a will which was deposited with the clerk of a competent court. A certified copy of the deposited will is attached. To the best of my knowledge and belief, the will deposited is the last will of the deceased and was signed by the deceased and the certifying witnesses in accordance with the law and would be eligible for probate hearing. The names and places of residence of the legatees and, if any, the portion of the estate to which each legatee is entitled are as follows:
| name, relationship | Age of | part of | and place of residence | irrelevant | estate |
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(Delete either 10(a) or 10(b)).
(c) Affiant is not aware of any dispute or potential conflict regarding the inheritance or will of the deceased.
10.3. My relationship to the testator or the testator's estate is as follows:.
10.5. (The following paragraph should appear in bold and a font size of at least 14 points):
I understand that the estate of the deceased must be
| | Distribution will be made first to satisfy claims against the testator's estate pursuant to Section 7.5 of this affidavit before distribution is made to an heir or legatee. By signing this affidavit, I agree to indemnify all creditors of the deceased's estate, the deceased's heirs and legatees, and any other person, corporation, or financial institution relying on this affidavit and suffering any loss as a result of reliance on this affidavit incurred, indemnify and hold harmless the amount lost by any act or omission on my part. I further understand that any person, company or financial institution receiving compensation under this Indemnification Provision will be entitled to reasonable attorneys' fees and costs of recovery.
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| 11. After I have discharged all of the debts and expenses listed in paragraph 7 of the estate of the deceased, the remaining property described in paragraph 6 of this affidavit should be distributed as follows:
NameSpecific sum or property to be distributed
The foregoing statement is made under penalty of perjury*.
.........................
Signature of Affiant
Signed in front of me and sworn on (insert date).
.........................
Uses
*(Note: Fraudulent statement made under penalty of perjury is perjury within the meaning of Section 32-2 of the Criminal Code 2012.)
(c) Appointment of a Representative. When access to a safe is required or when the sale of personal property is desirable to facilitate distribution under the small estate affidavit, the insured may, under the small estate affidavit, provide in writing to one or more individuals appoint as representative of the insured for this purpose. The Agent is authorized without court authorization to access the property, sell it and distribute it in the manner specified in paragraphs 7.5 and 11 of the Affidavit; and payment, delivery, transfer, access or issuance is made to or at the direction of the agent. The Insured may appoint himself as a nominated agent to exercise the powers and duties of an agent described in this sub-section (c).
(d) Trust and Liberation. Any person, corporation, or financial institution acting in good faith and relying on a copy of a document that is an affidavit of small estate and which is substantially consistent with subsection (b) of this section is fully protected and shall be released upon payment and delivery, transfer, access or issuance pursuant to such document to the same extent as if the payment, delivery, transfer, grant of access was made or granted to the agent of the estate. Such person, company or financial institution is under no obligation to see to apply for or dispose of the property; but any person to whom any payment, delivery, transfer, access or issue is made or granted is responsible therefor to any person having an earlier right and is accountable to any representative of the estate.
(e) Distributions may be made to the insured pursuant to an affidavit substantially in the form set out in sub-paragraph (b) of this Section, if so provided in paragraph 11, notwithstanding disclosure of known unpaid debts. The insured acting on behalf of the deceased's estate is required to settle any legitimate claims against the deceased's estate before any distribution is made to an heir or legatee. The creditor who signs the small estate affidavit prepared pursuant to subsection (b) of this Section represents all creditors, heirs and legatees of the decedent, and any other person, corporation, or financial institution who relies on the affidavit and any loss arising from that reliance suffer harmless . This indemnity is limited to the amount lost as a result of the insured's act or omission. Any person, entity or financial institution seeking recovery under this subsection (e) shall be entitled to reasonable attorneys' fees and the costs of recovery.
(f) The attorney-in-fact of a small estate affidavit that is not a resident of Illinois submits to the jurisdiction of the Illinois courts in all matters relating to the making or use of the affidavit. The affidavit must contain the name, address, and telephone number of a person whom the affidavit designates as his agent for service of the process. If no such person is named, or if service on the named person cannot be effected for any reason, the clerk of the district or judicial district in which the deceased was domiciled at the time of his death shall be the process agent.
(g) Any action duly taken under this Section, as amended by Public Act 93-877, on or after 6 August 2004 (the effective date of Public Act 93-877) shall be effective regardless of the date of death of the deceased.
(h) The amendments made by this 96th General Assembly Amendment Act shall apply to a deceased whose date of death is on or after the enactment of this 96th General Assembly Amendment Act.
(i) The amendments made by this 98th General Assembly Amendment Act shall apply to a deceased whose date of death is on or after the entry into force of this 98th General Assembly Amendment Act.
(Source: P.A. 97-1150, valid 1-25-13; 98-836, valid 1-1-15.)
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