Free $$WRK2$$ - Illinois

2621 Receipt on Distribution IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - PROBATE DIVISION Estate of

(Rev. 7/5/00) CCP 0379

_____________________________________________
Deceased

}

No. _______________________________ Docket _____________________________ Page ______________________________

RECEIPT ON DISTRIBUTION
I, _________________________________________________________________________, acknowledge receipt of
(name)

my share of this estate as follows:

I appear, waive notice, and consent to the approval of the __________________________________________
(current) (final)

account of ______________________________________________________________________________________
(name and office)

___________________________________________________________________________________________________, and I consent to the fees of the representative in the amount of $ _________________________________ and the fees of the attorney in the amount of $_____________________________ as set forth in the accounting. Atty. No.:__________________ Firm Name: ___________________________________________ Name: ________________________________________________ Atty. for Petitioner: __________________________________ Address: ____________________________________________ City/State/Zip: ________________________________________ Telephone: __________________________________________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS _______________________________________________ Distributee Address________________________________________ _______________________________________________