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AN AFFIDAVIT TO JESSE WHITE, THE SECRETARY OF THE STATE OF ILLINOIS, PURSUANT TO 755 ILCS 5/ART. XXV OF
THE PROBATE ACT, ILLINOIS COMPILED STATUTES, AS AMENDED BY PUBLIC ACT 9 8 - 0 836 (EFF. 1-1-15).
STATE OF ILLINOIS
COUNTY OF ________________________

SMALL ESTATE AFFIDAVIT
I,

(name of affiant), on oath state:
1.

(a) My post office address is:
(b) My residence address is:_______________________________________________________________________________; and
(c) I understand that if I am an out-of-state resident I submit myself to the jurisdiction of Illinois courts for all matters related to the
preparation and use of this affidavit. My agent for service of process in Illinois is:

NAME:

ADDRESS:

CITY:

TELEPHONE:

I understand that if no person is named above as my agent for service or, if for any reason, service on the named person cannot be
effectuated, the Clerk of the Circuit Court of
(County) ___________________________________
(Judicial Circuit) Illinois