PC-G-15.4C (Rev. 1-2004) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. A. BELSKIS, JUDGE LAWRENCEMONTGOMERY, JUDGE IN THE MATTER OF THE GUARDIANSHIP OF CASE NO. APPLICATION TO TERMINATE GUARDIANSHIP Now comes the undersigned guardian of the above named ward and represents to the Court, that the guardianship should be terminated for the following reason: [check appropriate box] The ward is over 18 years of age. The ward is now deceased. Other Therefore, the applicant asks the Court for authority to terminate the guardianship and to disburse the assets according to law as detailed in the Entry. Guardian ENTRY Upon consideration of the Application to Terminate Guardianship, the Court finds that there is no further need for the guardianship to remain open. Therefore, it is ordered that the guardianship be terminated forthwith and the financial institution shall on all account(s), relative to this guardianship in their Custodial Depository, disburse the funds to: The ward's estate only. The ward individually. The financial institution shall supply Probate Court with a complete accounting of all transactions against the account(s) since placed in their Custodial Depository or since the last account was submitted to Probate Court. The guardian is: Not required to file a final account because all the funds are custodial. The surety, if any, and the fiduciary are discharged. Required to file a final account by . Date LAWRENCE A. BELSKIS ROBERT G. MONTGOMERY Probate Judge Judge FRANKLIN COUNTY FORM 15.4C - APPLICATION TO TERMINATE GUARDIANSHIP American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. RECEIPT AND RELEASE OF ALL CLAIMS This day the undersigned makes application to the Probate Court for release of funds, including interest, deposited in: Financial Institution Account No. Amount I, , acknowledge the accuracy of the balance of the above listed funds deposited in the noted financial institution(s). `In consideration of the protection given my interest in the funds in the account(s) and in consideration of the release of the account(s), I hereby knowingly and voluntarily release Franklin County Probate Court, and all Court personnel from all actions, claims, damages and demands whatsoever which I now have or ever had or shall have which are associated with the receiving and holding of funds. Date Name Witness Signature NOTE: If not signed in Probate Court, this must be signed before a notary public. Acknowledged before me a Notary Public this day of , 20 . Notary Public American LegalNet, Inc. www.FormsWorkFlow.com