Insolvency Schedule Of Claims {24.4}

PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE ESTATE OF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB DECEASED CASE NO.BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB INSOLVENCY SCHEDULE OF CLAIMS [R.C. 2117.15, 2117.17, 2117.25] 7KH ILGXFLDU\ VWDWHV WKDW WKLV 6FKHGXOH RI &ODLPV OLVWV DOO FODLPV ZKLFK DUH SUHVHQWHG RU VHFXUHG 7KH FODLPV DUH OLVWHG E\ FODVVHV DQG LQ WKH RUGHU RI SULRULW\ RI SD\PHQW SXUVXDQW WR 6HFWLRQ RI WKH 2KLR 5HYLVHG &RGH Use extra sheets if necessary BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB )LGXFLDU\ 3DJH BBBB RI BBBB 3DJHV [Note: Include a subtotal following each payment class and a grand total for all payment classes.] _________________________________________________________________________________________________________________ Name and Address Payment Amount Estimated Claim of Claimant Class Claimed Payment 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