PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF THE GUARDIANSHIP OF CASE NUMBER GUARDIAN'S BOND [R.C. 2109.04(A)(1)] Amount of bond $ The undersigned principal, and sureties if any, are obligated to the State of Ohio in the above amount, for payment of which we bind ourselves and our successors, heirs, executors, and administrators, jointly and severally. The principal has accepted in writing the duties of fiduciary in ward's estate, including those imposed by law and such additional duties as may be required by the Court. This obligation is void if the principal performs such duties as required. This obligation remains in force if the principal fails to perform such duties, or performs them tardily, negligently, or improperly, or if the principal misuses or misappropriates estate assets or improperly converts them to the principal's own use or the use of another. (Check if personal sureties are involved.) The sureties certify that each of them owns real estate in this county, with a reasonable net value as stated below. Date Surety by Attorney in Fact Typed or Printed Name Address Principal Surety by Attorney in Fact Typed or Printed Name Address Net Value of real estate owned in this county $ Net Value of real estate owned in this county $ 15.3 GUARDIAN'S BOND Amended: 03/15/2016 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com