COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Estate Tax Division Estate Tax Form 21 Revised 7/03 Index No. Date Received by Ohio Department of Taxation : 800 Freeway Drive North Columbus, OH 43229-5404 1 (800) 977-7711 www.ohio.gov/tax : Plaintiff(s) Calendar No. JUDICIAL SUBPOENA -against: Application for Certificate of Release of Ohio Estate Tax Lien Estate of: Decedent’s last name County in Ohio Decedent’s first name and initial : Date of death : Decedent’s social security # Case number Defendant(s) Has an Ohio estate tax return been filed? : Yes . ............. Part. I. –.Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No If “yes,” give date it was filed Name of preparer Month Address Day – THE PEOPLE OF THE STATE OF NEW YORK Year – Amount of tax paid or to be paid City, state and ZIP code TO $ Telephone number of preparer Please circle appropriate title (including ancillary executor or administrator): Attorney Executor . Administrator(s) GREETINGS: List the approximate value of the real estate on the appropriate schedule below, list all WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before other gross assets under “All Other Property,” then list deductions as shown. , the Honorable at the Court located at County of Approximate Gross Estate Values Name and address of the purchaser, transferee, in room , on the day of , 20 , at o'clock in the or mortgagee and state noon, and at any recessed relation to applicant Schedule A or adjourned date, to testify and give evidence as a witness in this action on the part of the $ decedent. Real estate Schedule E Jointly owned property $ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Schedule G $ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Transfers during decedent’s life result of your failure to comply. Schedule H Power of appointment property Witness, Honorable All other property Court in County, $ Purchase/sales price on property: , one of the Justices of the $ day of Total gross estate $ J Debts and expenses of administration $ K Charitable deductions $ L Marital deduction $ T Qualified family-owned business interest deduction $ Total deductions (schedules J, K, L & T) , 20 $ . $ Will the estate be claiming any of the following on the estate tax return (Estate Tax Form 2): (Attorney must sign above and type name below) Yes No Attorney(s) for Yes No Current agricultural use valuation (CAUV) per O.R.C. Section 5731.011 Extension of time to pay estate tax per O.R.C. Section 5731.25 Office and P.O. Address To be completed by the Ohio Department of Taxation The application for this release of Ohio estate tax lien is: Tax Commissioner Telephone No.: Approved Not Approved Facsimile No.: By E-Mail Address: Mobile Tel. No.: Date American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Submit this form in duplicate to: Ohio Department of Taxation Estate Tax Division 800 Freeway Drive North Columbus, OH 43229-5404 or Plaintiff(s) Fax (614) 387-1984 -againstDocuments to be attached: Estate Tax Form 21 Revised 7/03 Page 2 Index No. : Calendar No. : JUDICIAL SUBPOENA : : 1. Copy of will and letters of administration or testamentary, if any. tal sheets, if necessary. Include parcel number and ad: dress of property to be released. Defendant(s) : ............ . ..... ... .. .... 2. Copy of contract. of. sale, if .any. . . . . . . . . . . . . . . . . . . . . . . 4. .Attach. a statement of the reasons why you are applying for a release. 3. List below a description of the property to which this application applies, showing the value of the p r o p e r t y 5. Attach a copy of the latest real estate tax bill received or THE PEOPLE OF THE STATE OF NEW YORK and the basis of the valuation. Continue on supplementhe Auditor’s tax card. TO This certificate releases the lien of the state of Ohio imposed by O.R.C. Section 5731.37 on the property described below: GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the 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. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com