Insolvency Schedule Of Claims {24.4}

PROBATE COURT OF ________________ COUNTY, OHIO ________________, JUDGE ESTATE OF_________________________________________________, DECEASED CASE NO. _______________________ INSOLVENCY SCHEDULE OF CLAIMS [R.C. 2117.15, 2117.17, 2117.25] The fiduciary states that this Schedule of Claims lists all claims which are presented or secured. The claims are listed by classes and in the order of priority of payment pursuant to Section 2117.25 of the Ohio Revised Code. (Use extra sheets if necessary) ____________________________________________ Fiduciary Page _____ of _____ Pages [Note: Include a subtotal following each payment class and a grand total for all payment classes.] ____________________________________________________________________________________ Name and Address of Claimant Payment Class Amount Claimed Estimated Payment Claim Rejected: Y/N ____________________________________________________________________________________ 1. (1) Comments (Refer to Claim Number) ______________________________________________________________ _____________________________________________________________________________________________ FORM 24.4 - SCHEDULE OF CLAIMS Effective Date: January 1, 2012 American LegalNet, Inc. www.FormsWorkFlow.com