PROBATE COURT OF CUYAHOGA COUNTY Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF _________________________________________, A MINOR CASE NUMBER: _____________________________ APPLICATION TO PAY OR DELIVER ESTATE OF A MINOR WITHOUTAPPOINTMENT OF A GUARDIAN OF ESTATE (R.C. 2111.05) Applicant states that __________________________________ has in possession certain property, towit: ____________________________________________________________________________________ ___________________________________________ belonging to the following named minor: ______________________________________________________________________________________________________________________N ame of minor DOB Address Applicant further states that minor has no legally appointed guardian of the estate and that the property to be delivered is less than $25,000.00. The names and addresses of the parents are: Mother: ________________________________________________________________________________ Father: _________________________________________________________________________________ Applicant asks that the property be delivered as follows: ______ Delivered to _______________________________as Custodian for the use and benefit of the minor. ______ Deposited in a financial institution, to-wit: _________________________________________ in the name of the minor until minor attains the age of majority (18 years of age). __________________________________________ Attorney for Applicant ____________________________________________ Parent/Custodian _______________________________________ ___ Typed or printed name ____________________________________________ Typed or printed name __________________________________________ Address __________________________________________________________ City State Zip _________________________________________________________ Telephone Number (include area code) ________________________________________________________ Registration Number ____________________________________________ Address _____________________________________________________________ City State Zip _____________________________________________________________ Telephone Number (include area code) American LegalNet, Inc. www.FormsWorkFlow.com  PROBATE COURT OF CUYAHOGA COUNTY Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF _________________________________________ CASE NUMBER: _____________________________ PAY OR DELIVER THE PROPERTY OF A MINOR ACKNOWLEDGMENT OF RESPONSIBILITY The parents/custodians of the above referenced minor hereby acknowledge that they have participated in a Pay or Deliver proceeding for their minor child. The undersigned further understand that monies belonging to the minor have been placed into a controlled account at a financial institution to be held for the benefit of the minor, and understand and acknowledge that it is their responsibility to insure that the minor is informed of this account and has the opportunity to receive all available funds upon attaining the age of eighteen (18) years. ___________________________ Date __________________________________ Parent/Custodian ___________________________ Date ___________________________________ Parent/Custodian POD - ACKNOWLEDGMENT American LegalNet, Inc. www.FormsWorkFlow.com