Illinois Small Estate Affidavit
Pursuant to the Illinois Probate Act, 755 ILCS 5/25-1, this document serves as an affidavit for the collection of the personal property of a decedent whose estate meets the criteria established under the aforementioned statute. This form is intended for use when the total value of the decedent's entire personal estate, including assets passing outside the will or intestacy does not exceed $100,000.
Section 1: Decedent Information
Full Legal Name of Decedent: ___________________________________________________
Date of Death (MM/DD/YYYY): _________________________
County of Decedent’s Primary Residence: __________________________________________
Last Four Digits of Decedent's Social Security Number: _____________________________
Section 2: Affiant Information
Full Legal Name of Affiant: ____________________________________________________
Relationship to Decedent: ______________________________________________________
Address of Affiant: ____________________________________________________________
City, State, Zip Code: __________________________________________________________
Telephone Number: _______________________ Email Address: ________________________
Section 3: Asset Information
Please provide a detailed list of the decedent's personal property and the estimated value of each item. Include all bank accounts, stocks, bonds, vehicles, and any other personal assets.
- Description of Asset: ____________________________________ Value: $__________
- Description of Asset: ____________________________________ Value: $__________
- Description of Asset: ____________________________________ Value: $__________
Section 4: Debts and Liabilities
List all known debts and liabilities of the decedent at the time of death.
- Creditor: ___________________________ Amount Owed: $__________
- Creditor: ___________________________ Amount Owed: $__________
- Creditor: ___________________________ Amount Owed: $__________
Section 5: Declaration
I, _____________________(Affiant’s Name), declare under penalty of perjury that the information provided in this affidavit is true and correct to the best of my knowledge and belief. I understand that this document is executed for the purpose of collecting the personal estate of the decedent and that the estate qualifies as a "small estate" under Illinois law. I agree to use the assets collected for the payment of the decedent’s debts and liabilities and to distribute any remaining assets according to the decedent’s will or in accordance with Illinois intestacy laws, if applicable.
_____________________ Date: _______________
___________________________________________
Affiant’s Signature
Notary Public Acknowledgment
State of Illinois
County of ________________
Subscribed and sworn to (or affirmed) before me on this day, ____________, by _____________________________________________ (Affiant), who is personally known to me or who has produced ___________________________ as identification.
___________________________________________
Notary Public Signature
My Commission Expires: _______________