Application To Relieve Estate From Administration

Probate Court of Cuyahoga County, Ohio John J. Donnelly, Presiding Judge John E. Corrigan, Judge ESTATE OF _______________________________________________________, DECEASEDCASE NUMBER: ______________________________________ APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION [R.C. 2113.03] Applicant says that decedent died on ___________________________________ ________________________________ Decedents domicile was _____________________________________________ ________________________________ Street Address ________________________________________________________________________ _________________________ City or Village, or Township if unincorporated area County________________________________________________________________________ _________________________ Post Office State Zip Code[Check one of the following] G Decedents will has been admitted to probate in this Court G To applicants knowledge, decedent did not leave a will. [Check one of the following] G The assets are $15,000 or less and decedent died on or after January 1, 1976 G The assets are $25,000 or less and decedent died on or after October 20, 1987 G The assets are $35,000 or less and decedent died on or after November 9, 1994 G The assets are $50,000 or less, the surviving spouse is entitled to all of the assets and the decedent died on or after April 16, 1993 G The assets are $85,000 or less; the surviving spouse is entitled to all of the assets and the decedent died on or after September 14, 1993 G The assets are $100,000 or less; the surviving spouse is entitled to all of the assets and the decedent died on or after March 18, 1999 Applicant asks that the estate be relieved from administration because t he assets do not exceed the statutory limits. A statement of theassets and liabilities is listed on the attached Form 5.1 The decedents surviving spouse, next of kin, legatees, and devisees known to applicant, are listed on the attached Form 1.0.___________________________________________ ___________________________________________ Attorney for Applicant Applicant ___________________________________________ ___________________________________________ Typed or Printed Name Typed or Printed Name ___________________________________________ ___________________________________________ Address Address ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ Phone Number (include Area code) Phone Number (include Area code) ___________________________________________ ___________________________________________ Attorney Registration No. _______________________ Form 5.0 APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 WAIVER OF NOTICE The undersigned surviving spouse, heirs at law, legatees, devisees and o ther persons entitled to notice of the filing of theapplication to relieve decedents estate from administration, waive s uch notice. _________________________________________ ______________________________________ _________________________________________ ______________________________________ _________________________________________ ______________________________________ _________________________________________ ______________________________________ ENTRY SETTING HEARING AND ORDERING NOTICE The Court sets ____________________________ , at ___________ oclock _____ . M, as the date and time for hearing the application to relieve decedents estate from administrat ion. [Check one of the following] G All notice is dispensed with as unnecessary. G Notice by publication to interested parties is dispensed with as unneces sary. Written notice shall be given, asprovided by law and the Rules of Civil Procedure, to those persons entit led to notice, who have not waived notice.G Written notice is dispensed with as unnecessary. Notice by publication shall be given to interested parties asprovided by law and the Rules of Civil Procedure. G Written notice shall be given to those persons entitled to notice, who h ave not waived notice, and notice bypublication shall be given to interested parties, as provided by law and the Rules of Civil Procedure. _________________________________________ _________________________________Date Probate Judge American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3 Probate Court of Cuyahoga County, Ohio John J. Donnelly, Presiding Judge John E. Corrigan, Judge ESTATE OF _________________________________________________________________, DECEASED CASE NUMBER: ______________________________________ ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION Following is a summary statement of the character and value of the asset s in decedents estate [insert a check in the Appraised colum nopposite 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 affidavit Value________________________________________________________________________ ________________________________ First automobile selected by surviving spouse under R.C. 2106.18 [Omit value when computing total assets]- - - - - - - - Appraised value $ ________________________________________________________________________ ________________________________ First automobile selected by surviving spouse under R.C. 2106.18 [Omit value when computing total assets]- - - - - - - - Appraised value $ ________________________________________________________________________ ________________________________ Total Value [not to exceed $40,000] $ ________________________________________________________________________ ________________________________ Character of asset Appraised Value________________________________________________________________________ ________________________________ Real estate, described in accompanying Certificate of Transfer No. ________________________________________________________________________ _______________$____________________________________________________________________________________________________ ________________________________ Other assets $ ________________________________________________________________________ _______