COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. Estate Tax Form 18 Revised 7/03 : Calendar No. : JUDICIAL SUBPOENA Estate Tax Division 800 Freeway Drive North Columbus, OH 43229-5404 1 (800) 977-7711 www.ohio.gov/tax Plaintiff(s) -against- : Close Corporation Valuation Form : Estate of: Decedent’s last name Decedent’s first name and initial Date of death : Defendant(s) Case number : ...................................................... County in Ohio Decedent’s social security number Name of corporation THE PEOPLE OF THE STATE OF NEW YORK TO Item I. Preferred Stock The number of shares of preferred stock owned by decedent . The book values and dividends of said company’s preferred stock per share for the past five years are as follows: GREETINGS: Year ending Dividends per share Book value per share Based on following number of shares then outstanding 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. The preferred stock has a par value of $ per share. The nominal dividend rate is %. It is cumulative , , date of death on the the noncumulative Witness, HonorableThe amount of accumulated dividends as of the one of the Justices of above preferred , participating . Court County, day , stock was $ in . This stock is callable of , non-callable 20 . Item II. Common Stock (Attorney must sign aboveand type name below) The number of shares of common stock owned by decedent . The book values and dividends of said company’s common stock per share for the past five years are as follows: Year ending Attorney(s) Book value per share for Dividends per share Based on following number of shares then outstanding Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: The common stock has a par value of $ per share. American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. Item III. Statement of Earnings : Estate Tax Form 18 Rev. 7/03 Page 2 Index No. The following is a statement of the profit or loss (after income tax but before dividends) for the last five years indicated and also a statement representing earnings per share for said common stock:: Calendar No. Net profit (or loss)a Year ending Plaintiff(s) Based on following number Earnings : per shareb JUDICIAL of shares then outstanding SUBPOENA -against- : : : (a) . . . . . any . . . . . . . . . . . . . . . Do not .deduct . . . dividends .paid.during year.. Defendant(s) : . .(b) To. arrive at.the earnings per.share.for common stock, deduct dividend requirements of preferred .. ..... .......... ... . stock and divide remainder by the number of shares of common stock then outstanding. Item IV. Sales Evidence The following is a list of the sales of the OF NEW YORKmade within a reasonable period of time prior to and/or after the THE PEOPLE OF THE STATE corporate stock, date of death. TO Common/Preferred Shares Sold Number Date Seller Price Buyer Broker 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 Data and give evidence as a witness in this action on the part of the testify Item V. Incorporation Incorporated under the state of When Principal place ofYour failure to comply with state, ZIP code) is business (street address, city, this subpoena 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. Nature of business (If additional space is needed, use Additional Comments section on page 3.) Witness, Honorable Court in County, President , one of the Justices of the day of , 20 Vice-President (Attorney must sign above and type name below) Treasurer Secretary Attorney(s) for being first duly sworn deposes and says that he/she is the President, Vice-President, Treasurer, Secretary of the corporation and that he/she has examined the books and records of Office and P.O. Address said company which disclose the above facts; that the same represents a true copy of the records of said corporation. Signature of officer Telephone No.: Sworn to and subscribed before me this Facsimile No.: , 20 E-Mail Address: Mobile Tel. No.: day of Notary public Title . American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Additional comments: Estate Tax Form 18 Rev. 7/03 Page 3 Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... Item VI. Additional Information THE PEOPLE OF THE STATE OF a fair evaluation of the corporation. This information is needed in order to makeNEW YORK The appropriate NAICS (North American Industry Classification System) Code: TO Briefly summarize: 1. Company operations: 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 2. Company history and present status: 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 3. Economic outlook of industry: Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : 4. Share of market: Estate Tax Form 18 Rev. 7/03 Page 4 Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... 5. Economic outlook of status of business: THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable Used in Valuation at the Court Item VII. Method located at County of in room on the day of , at o'clock in the noon, and at any recessed Please provide a detailed,outline of the valuation method. , 20 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