Statement In Lieu Of Account {13.0B}

PC-E-13.0B (Rev. 5-2001) PROBATE COURT OF FRANKLIN COUNTY, OHIO LAWRENCE A. BELSKIS, JUDGE ROBERT G. MONTGOMERY,JUDGE ESTATE OF CASE NO. , DECEASED STATEMENT IN LIEU OF ACCOUNT The undersigned fiduciary of the above matter states: that no personal property of any kind or amount has come to my possession or knowledge as fiduciary. that I have assets in my possession as shown on my last account or inventory and which I am exhibiting. I further state that I have made no distribution and received no other assets except interest income credited to the same account. The fiduciary further states that this estate is still pending for the following reason: Date Attorney Typed or Printed Name Address City, State, Zip Code Telephone Number Attorney Registration Number Fiduciary Typed or Printed Name Address City, State, Zip Code Telephone Number FRANKLIN COUNTY FORM 13.0B - STATEMENT IN LIEU OF ACCOUNT American LegalNet, Inc. www.FormsWorkFlow.com