PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge ESTATE OF _______________________________________________________, DECEASED CASE NUMBER ______________________________________ FIDUCIARY'S ACCOUNT (R.C. 2109.30, 2109.301 and 2109.32) [Executors and Administrators] The fiduciary offers the account given below and on the attached itemized statement of receipts and disbursements. The fiduciary states that the account is correct, and asks that it be approved and settled. [Check one of the following] 9 This is a partial account. A statement of the assets remaining in the fiduciary’s hands is attached. 9 This is a final account. A statement of the assets remaining in the fiduciary’s hands for distribution to the beneficiaries is attached. 9 This is an account of distribution and the fiduciary asks to be discharged upon its approval and settlement. 9 This is a final and distributive account and the fiduciary asks to be discharged upon its approval and settlement. 9 This is a supplemental final account. [Complete if this is a partial account, or if one or more accounts have previously been filed in the estate] The period of this account is from __________________________________________________ to ____________________________________________________ [Complete if applicable] Accounts previously filed in the estate, the accounting periods, and the fiduciary and attorney fees paid for each period, are as follows: Date Filed Accounting Period Fiduciary Fees Paid $ Attorney Fees Paid $ Note: 2117.06(K) states: “The distributee may be liable to the estate up to the value of the distribution and may be required to return all or any part of the value of the distribution if a valid claim is subsequently made against the estate within the time permitted under this section.” 2109.32(C) states: “The rights of any person within a pecuniary interest in the estate are not barred by approval of an account pursuant to division (A) and (B) of this section. These rights may be barred following a hearing on the account pursuant to section 2109.33 of the Revised Codes. Form 13.0 - FIDUCIARY'S ACCOUNT 01/02 American LegalNet, Inc. www.FormsWorkflow.com CASE NUMBER __________________________ This account is recapitulated as follows: RECEIPTS Personal property not sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________________ Proceeds from sale of personal property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Real property not sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Proceeds from sale of real estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Other receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Total receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________________ DISBURSEMENTS Fiduciary fees [this accounting period] .. . . . . . . . . . . . . . . . $___________________ Attorney fees [this accounting period] . . . . . . . . . . . . . . . . . ____________________ Other administration costs and expenses . . . . . . . . . . . . . . ____________________ Debts and claims against estate . . . . . . . . . . . . . . . . . . . . . . ____________________ Ohio and federal estate taxes .......... ........... ____________________ Personal property distributed in kind . . . . . .. . . . . . . . . . . ____________________ Real property transferred . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Other distributions to beneficiaries . . . . . . . . . . . . . . . . ____________________ Other disbursements . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________ Total disbursements . . . . . . . . . . . . . . . . . . . . . . $ ____________________ BALANCE REMAINING IN FIDUCIARY’S HANDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________________ _______________________________________ ___________________________________________ Attorney Fiduciary __________________________________________ ___________________________________________ Date Registration Number ENTRY SETTING HEARING The Court sets ______________________________________ at __________ o’clock ____. M. as the date and time for hearing the above account. __________________________________________ Date ___________________________________________ Probate Judge American LegalNet, Inc. www.FormsWorkflow.com PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge ESTATE OF _______________________________________________________, DECEASED CASE NUMBER ______________________________________ RECEIPTS AND DISBURSEMENTS [Attach to fiduciary’s account] Page ________ of _________ pages Following is an itemized statement of receipts and disbursements by the fiduciary in the administration of his trust. Item Voucher No. Value or Amount Value or Amount $ $ Form 13.1 - RECEIPTS AND DISBURSEMENTS American LegalNet, Inc. www.FormsWorkflow.com Page _________ of _________ Item Voucher No. Value or Amount Value or Amount $ $ _____________________________________ Fiduciary American LegalNet, Inc. www.FormsWorkflow.com PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge ESTATE OF _______________________________________________________, DECEASED CASE NUMBER ______________________________________ ASSETS REMAINING IN FIDUCIARY’S HANDS [ATTACH TO PARTIAL OR FINAL FIDUCIARY’S ACCOUNT] Page ________ of _________ pages The estate assets remaining in the fiduciary’s hands are recapitulated as follows: Tangible personal property ............. ........................................ $_________________ Intangible personal property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________ Total personal property . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________ Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________ Total assets remaining in fiduciary’s hands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Following is an itemized statement of estate assets remaining in the fiduciary’s hands. Item Voucher No. Value or Amount Value or Amount $ $ Form 13.2 - ASSETS REMAINING IN FIDUCIARY’S HANDS American LegalNet, Inc. www.FormsWorkflow.com Page ________ of _________ pages Item Voucher No. Value or Amount Value or Amount $ $ _________________________________________ Fiduciary American LegalNet, Inc. www.FormsWorkflow.com