COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.ERIEPROBATE COURT OF COUNTY, OHIOJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ESTATE OF , DECEASED CASE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ENTRY APPROVING SETTLEMENT AND DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMSTHE PEOPLE OF THE STATE OF NEW YORK TOUpon hearing the application to approve settlement and distribution of the wrongful death and survival claims, the Court:GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomApproves the proffered settlement of $. Orders payment of $ to be applied to decedent's funeral and burial expenses. Orders payment of $ to the fiduciary for services rendered with respect to the wrongful death and survival claims. Orders payment of $ to the attorney for reimbursement of case expenses and $ for attorney fees for services rendered with respect to the wrongful death and survival claims. Orders that the net proceeds of $ be allocated $ to the wrongful death claim and $ to the survival claim. The amount allocated to the survival claim shall be considered an asset of the estate and shall be reflected in the fiduciary's account of the administration of the estate. Finds all of the beneficiaries of the wrongful death claim are on an equal degree of consanguinity, are adults, and have agreed how the net proceeds allocated to the wrongful death claim are to be distributed. Orders distribution of the net proceeds allocated to the wrongful death claim to the surviving spouse, children, parents and other next of kin, in the equitable shares shown below, fixed by the Court having due regard for the injury and loss to each beneficiary resulting from the death and for the age and condition of the beneficiaries.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,NameResidenceAmount AddressBirthdateRelationshipof Minorto Decedent(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressFORM 14.2 ENTRY APPROVING SETTLEMENT AND DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMS4/97Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.Orders that the share of:JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)a minor(s) be deposited in lieu of bond pursuant to R.C. 2111.05.R.C. 2111.05.a minor(s) be paid to the guardian of the estate of such minor.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a child(ren) be deposited in a trust for the benefit of the child(ren) until twenty-five years of age.THE PEOPLE OF THE STATE OF NEW YORK TOAuthorizes the fiduciary to execute a release which, upon payment, shall be a discharge of the claim. Orders the fiduciary and the attorney to report the distribution of the proceeds within thirty days of the date of this Entry. Further ordersGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomApproved:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Attorney for FiduciaryProbate Judge, one of the Justices of theAttorney Registration No.DateCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com