Application For Summary Release From Administration {5.10}

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.ERIEPROBATE COURT OF COUNTY, OHIOJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ESTATE OF , DECEASED CASE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(R.C. 2113.031)APPLICATION FOR SUMMARY RELEASE FROM ADMINISTRATION [R.C. 2113.031] Applicant states that decedent died on Decedent's domicile wasTHE PEOPLE OF THE STATE OF NEW YORK TOStreet AddressCity or Village, or Township if unincorporated areaCountyPost OfficeStateZip CodeGREETINGS:[Check one of the following] WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,The applicant is decedent's surviving spouse entitled to one hundred percent of the allowance for support and decedent's funeral and burial expenses have been prepaid or the surviving spouse has paid or is obligated in writing to pay decedent's funeral and burial expenses and the value of the assets does not exceed the $40,000 allowance for support under R.C. 2106.13(B) plus an amount not exceeding $2,000 for decedent's funeral and burial expenses.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 roomR.C. 2106.13 (B)The applicant, who is not the surviving spouse, has paid or is obligated in writing to pay decedent's funeral and burial expenses and the value of the assets is the lesser of $2,000 or the amount of decedent's funeral and burial expenses.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 $50 and all damages sustained as a result of your failure to comply.Attached hereto is a receipt, contract or other document that confirms the applicants payment or obligation to pay decedent's funeral and burial expenses or if the applicant is the surviving spouse, the prepayment receipt, if applicable. The decedent's surviving spouse, next of kin, legatees and devisees known to applicant, are listed on attached Form 1.0. Applicant states that there are no pending proceedings for the administration of decedent's estate or relief of decedent's estate from administration under R.C. 2113.03. All known assets with date of death values of the estate are as follows: , one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)R.C. 2113.03Attorney(s) forMotor Vehicles (include year, make, model, body type, manufacturer's vehicle identification number and Certificate of Title number)Office and P.O. Address$Telephone No.: Facsimile No.: E-Mail Address:7/9/01FORM 5.10 APPLICATION FOR SUMMARY RELEASE FROM ADMINISTRATIONMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.(Reverse of Form 5.10)Accounts maintained by a Financial Institution (include financial institution name and the account's complete identifying number:JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)$Stocks and Bonds (include for each stock or bond its serial number, the name of its issuer, the name and address of its transfer agent, and the total number of shares of stocks or bonds):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$THE PEOPLE OF THE STATE OF NEW YORK TOReal estate described in accompanying Form 12.0 Application for Certificate of Transfer and Form 12.1 Certificate of Transfer and date of death value. [Attach verification of value.]$Other assets and date of death values:GREETINGS:$WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,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 roomTotal Assets $Applicant requests an order granting summary release.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.Attorney for ApplicantApplicant's SignatureTyped or Printed NameApplicant's Typed or Printed Name, one of the Justices of theCourt in Witness, Honorableday of, 20 County,Street AddressStreet Address(Attorney must sign above and type name below)CityStateZip CodeZip CodeStateCityAttorney(s) forPhone Number (include area code)Phone Number (include area code)Attorney Registration No.Office and P.O. AddressSigned and acknowledged by the applicant in my presence this., 20day ofTelephone No.: Facsimile No.: E-Mail Address:Notary Public/Deputy ClerkMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>