PC-E-1.T (Rev. 1-2008) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY,JUDGE LAWRENCE A. BELSKIS, JUDGE ESTATE OF CASE NO. 438119 , DECEASED MOTION TO RELEASE INFORMATION Now comes Name , the Realtionship Date of Death of the above and hereby requests authority to named decedent who died obtain information regarding accounts and balances for the decedent at the following institution(s) for the purpose of pursuing an estate administration: Signature Typed or Printed Name Address City, State, Zip Telephone Number [include area code] JOURNAL ENTRY TO RELEASE INFORMATION For good cause shown the above named institutions are authorized to release financial information to the applicant concerning the above named decedent. THIS IS NOT AUTHORITY TO RELEASE FUNDS, ONLY INFORMATION CONCERNING THE FUNDS. LAWRENCE A. BELSKIS ROBERT G. MONTGOMERY Judge Probate Judge FRANKLIN COUNTY FORM 1.T - MOTION TO RELEASE INFORMATION American LegalNet, Inc. www.FormsWorkFlow.com