Free $$WRK1$$ - Illinois

4122 Order To Settle Cause of Action - Minors Estate IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - PROBATE DIVISION

(Rev. 8/21/01) CCP 0396

Estate of

________________________________________________________________ Minor

}

No. ________________________________________ Docket _____________________________________ Page ________________________________________

ORDER TO SETTLE CAUSE OF ACTION - MINORS ESTATE
On the verified petition of the guardian to settle a cause of action for injury, IT IS ORDERED that: 1. The cause of action be settled for $ _____________________ and, upon receiving that sum, the guardian execute and deliver to the party against whom the cause of action lies a release and discharge from all liability or covenant not to sue on account of the injuries; 2. The guardian distribute the proceeds of the settlement as follows: (Attach additional statement if necessary) Name Description Amount

To _____________________________ for ___________________________________ To _____________________________ for ___________________________________ To _____________________________ for ___________________________________ To _____________________________ for ___________________________________ * To ____________________________________________________________________
(name of depository)

To _____________________________ for ___________________________________

________________________ ________________________ ________________________ ________________________ ________________________

IN AN ACCOUNT IN THE NAME OF THE MINOR, TO BE HELD SUBJECT TO FURTHER ORDER OF COURT OR TO BE RELEASED TO THE MINOR WITHOUT FURTHER ORDER UPON THE ATTAINMENT OF MAJORITY ON

______________________________________, _________.
* To __________________________________________________________________ for benefit of the minor.
(name of guardian, parent or relative, stating relationship)

________________________ ________________________
(4171)
$ _______________________

Total disbursement

3. The guardian shall be discharged from further duty and the guardian and the surety on the bond shall be released from further obligation and the estate shall be closed upon the presentation of vouchers of disbursement in accordance with this order on

___________________________________, _________, at ______________ m. in Room ______________.

(6133)

4. If the guardian fails to present the report of distribution or vouchers without cause shown, the order approving costs and allowing the attorneys fee shall be vacated and a rule shall issue against the guardian requiring him to show cause why he/she should not be adjudged in contempt of court.

Atty. No.:__________________ Name: ______________________________________________ Atty. for Petitioner: __________________________________ Address: ____________________________________________ City/State/Zip: _______________________________________ Telephone: __________________________________________
*Strike if not applicable.

____________________________________, ________
ENTER:

______________________________________________
Judge Judges No.

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS