PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge ESTATE OF _______________________________________________________, DECEASED CASE NUMBER ______________________________________ CERTIFICATE OF TERMINATION [R.C. 2109.30] I certify I am the executor or administrator and the sole legatee, devisee or heir. I further certify: (1) all debts and claims presented to the estate have been paid in full or settled finally; (2) an estate tax return, if required under Chapter 5731 of the Revised Code, has been filed, and any estate tax due under that chapter has been paid; (3) all attorney fees have been [check one] 9 waived by counsel of record, 9 paid to counsel of record in the amount of $ ___________________________ (4) all fiduciary fees have been [check one] 9 waived by the fiduciary, 9 paid to the fiduciary in the amount of $ ___________________________. (5) all assets remaining after completion of the activities described above have been distributed to myself as the sole legatee, devisee or heir. ___________________________________ ___________________________________ Attorney for Fiduciary Fiduciary ___________________________________ Attorney Registration Number ENTRY Based upon the above certification it is ordered that the fiduciary and surety, if any, are discharged. ____________________________________ Probate Judge 13.6 - CERTIFICATE OF TERMINATION 8/99 American LegalNet, Inc. www.FormsWorkflow.com