Assets And Liabilities Of Estate To Be Relieved From Administration {5.1}

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF SUMMIT COUNTY, OHIOCalendar No., DECEASEDESTATE OFJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)CASE NO.ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Following is a summary statement of the character and value of the assets in decedent's estate. (Insert a check in the Appraised column opposite an item if it was valued by the appraiser. Leave blank if the readily ascertainable value of the item was determined by applicant. Use extra sheets if necessary.) Automobiles distributed to surviving spouse by affidavitTHE PEOPLE OF THE STATE OF NEW YORK TOValue First automobile selected by surviving spouse under R.C. 2106.18 (Omit value when computing total assets) .......................................................... Appraised value $ Second automobile selected by surviving spouse under R.C. 2106.18 (Omit value when computing total assets) .......................................................... Appraised value $GREETINGS:Total value (not to exceed $40,000.00)$Character of assetAppraisedValueWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,Real Estate, described in accompanying Certificate of Transfer No.$located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomOther assets$Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forTotal Assets$Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comForm 5.1COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.CASE NO. Calendar No.Following is a list of decedent's known debts. (Use extra sheets if necessary.)JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Name of CreditorNature of DebtAmount$. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,Total Debts$located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomCERTIFICATION Theundersignedappraiseragreedtoactasappraiserofdecedent'sestate,andtoappraisetheproperty exhibited truly, honestly, impartially, and to the best of the appraiser's knowledge and ability. The appraiserfurthersaysthatthoseassetswhosevalueswerenotreadilyascertainableareindicatedabove by a check in the Appraised column opposite each such item, and that such values are correct.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,The undersigned applicant determined the value of those assets whose values were readily ascertainable and were not appraised by the appraiser, and that such values are correct, and to applicant's knowledge the above list of decedent's debts is correct.(Attorney must sign above and type name below)Attorney(s) forDateAppraiserApplicantOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>