Free CCP 0492 7-5-00 - Illinois

2515 Statement of Notice to Trust Beneficiaries IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT-PROBATE DIVISION

(Rev. 7/5/00) CCP 0492

Estate of

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Deceased

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Case No. _____________________________ Docket No. __________________________ Page No. ____________________________

STATEMENT OF NOTICE TO TRUST BENEFICIARIES

The undersigned states under the penalties of perjury that: 1. A part or all of this estate is distributable to the trustee(s) of a trust, and each trustee of the trust is also a representative of this estate;

2. * (a) Notice of the hearing on the account under Section 24-2 of the Probate Act of 1975 (755 ILCS 5/1 et seq.) or * (b) Notice of the filing of the final report under Section 28-11 of the Probate Act has been given to or waived by all beneficiaries currently entitled to receive or eligible to have the benefit of the income from the trust; and 3. In the case of each beneficiary of the trust who is a minor or disabled person, notice has also been given to the guardian of the estate of the beneficiary or, if no guardian of the estate has been appointed, to the personal fiduciary for the beneficiary under Section 28-3 of the Probate Act or, if none, to the spouse, parent, adult, child, or guardian of the person of the beneficiary.

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(Representative) Atty. No.: ______________ Firm Name: ___________________________________ Date: ________________________________, _________ Attorney for: __________________________________ Address: _____________________________________ City/Zip: _____________________________________ Telephone: ____________________________________

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Attorney Certification (Sup. Ct. Rule 137)

*Strike whichever is not applicable.

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