Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ APPLICATION TO DISINTER BODY [R.C. 517.24] I, ________________________________________ , hereby make application to disinterment and removal of the remains of the dead body of: _____________________________________ now lying in ___________________________________ Cemetery located at _______________________________ who died on the ________ day of ______________________ , _____, the cause of death being : ______________________________________________________________ . The body is to be reinterred at _____________________________________________ located at ____________________________________ . Relationship of Applicant to Deceased ________________________________________________ . The applicant represents to the Court that he or she is eighteen years of age or older and of sound mind; and that he or she G did G did not assume responsibility for the funeral and burial expenses of the decedent. OATH I, __________________________________ being first duly sworn that the foregoing facts are true and correct. ______________________________________________ _______________________________________________ Signature Date Signed ______________________________________________ _______________________________________________ Address Area Code / Phone Number County of _____________________________________ State of _______________________________________ SS: Sworn to and subscribed before me a notary public on this ______________________ day of ______________________ _______________________________________________ Notary Public / Deputy Clerk Form 21.0 - Application to disinter body American LegalNet, Inc. www.FormsWorkflow.com Probate Court of Cuyahoga County, Ohio Atnhony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ NOTICE OF APPLICATION TO DISINTER BODY AND HEARING [R.C. 517.24 (B)(a)] TO: _______________________________________ You are hereby notified that ____________________________________ has filed an Application to Disinter the Body of _________________________________________________________ in the Cuyahoga County Probate Court located at 1 Lakeside Avenue, Cleveland, Ohio on ___________________________________________ , and that a hearing on this matter has been set before the Probate Court on ______________________________ . This notice is given to the decedent’s surviving spouse, all persons who would be entitled to inherit from decedent had the decedent died intestate, and all legatees and devisees named in the Will who do not waive notice. You are receiving this notice as: (Check all of the following that apply.) G The surviving spouse G A person who would be entitled to inherit from the decedent had the decedent died intestate. G A legatee or devisee named in the Will (beneficiary) Any objections to the disinterment of the decedent’s remains must be presented to the Court at the hearing. Form 21.1 - Notice of application to disinter body and hearing American LegalNet, Inc. www.FormsWorkflow.com Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ WAIVER OF NOTICE OF APPLICATION TO DISINTER BODY [R.C. 517.24 (B)(2)(a)] The undersigned surviving spouse, heirs, legatees, and devisees being persons entitled to notice of the filing of an application to disinter the decedent’s body, waive such notice. _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ Form 21.2 - Waiver of Notice of application to disinter body American LegalNet, Inc. www.FormsWorkflow.com Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ AFFIDAVIT OF SERVICE The undersigned applicant hereby states that all persons required to receive notice as provided in R.C. 517.24(B)(2)(a) have either been notified that an application to disinter the decedent’s remains has been filed, have waived notice, or their names or places of residence are unknown to the applicant and cannot with reasonable diligence be ascertained. Said waivers and/or evidence of notification are attached hereto. The following persons did not receive notice: _______________________________________________ _______________________________________________ Name Reason _______________________________________________ _______________________________________________ Name Reason _______________________________________________ _______________________________________________ Name Reason _______________________________________________ _______________________________________________ Name Reason _______________________________________________ Applicant County of __________________________________ ) SS: State of ____________________________________ ) Sworn to and subscribed before me a notary public on this _______________ day of _______________ ___________. _______________________________________ Notary Public / Deputy Clerk Form 21.3 - Affidavit of Service American LegalNet, Inc. www.FormsWorkflow.com Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ SURVIVING SPOUSE, NEXT OF KIN, LEGATEES AND DEVISEES The following are decedent’s known surviving spouse, and other known survivors who are or would be entitled to inherit under the statutes of descent or distribution. __________________________________________________________________________________________________________ Name Residence Relationship Birthdate Address to decedent of minor __________________________________________________________________________________________________________ Surviving Spouse __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ form 21.4 - surviving spouse, next of kin, legatees and devisees American LegalNet, Inc. www.FormsWorkflow.com Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN RE _____________________________________________________________ , DECEASED CASE NUMBER:______________________________________ ORDER FOR DISINTERMENT Upon hearing the application to disinter the decedent’s body, the Court finds that: The decedent’s remains are presently interred at: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Notice to the surviving spouse, heirs at law, legatees and devisees, was duly effected by the applicant or dispensed with as unnecessary. That no interested party has established that disinterment would be against the decedent’s religious beliefs. Therefore ir is ORDERED that the Application for Disinterment is hereby GRANTED. It is further ordered that the decedent’s remains shall be removed from their present place of interment and reinterred at: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ _____________________________________________ Date _______________________________________ Probate Judge form 21.5 - Order for disinterment American LegalNet, Inc. www.FormsWorkflow.com