PC-E-15.0 (Rev. 2-2015) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY, JUDGE ESTATE OF CASE NO. , DECEASED SCHEDULE OF CLAIMS [Sup. R. 62(B)] The fiduciary says that this schedule lists all claims against the decedent or this estate. The claims are recapitulated as follows: Claims allowed ....................................................................................................... $ Claims rejected, contingent, or in suit ..................................................................... $ Total .................................................................................................................... $ Attorney Fiduciary Attorney Registration No. [Under "Footnotes" opposite an item requiring explanation, place the number of the appropriate footnote. Such notes should be included on the reverse side to explain: any security for claims; maturity dates of claims not due; contingent claims; claims in suit; and dates of rejection of rejected claims] Name and Address of Claimant Amount Claimed Payment Class Date Presented Date Allowed Footnotes $ FRANKLIN COUNTY FORM E-15.0 - SCHEDULE OF CLAIMS (PAGE 1) American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. Name and Address of Claimant Amount Claimed Payment Class Date Presented Date Allowed Footnotes $ FOOTNOTES FRANKLIN COUNTY FORM E-15.0 - SCHEDULE OF CLAIMS (PAGE 2) American LegalNet, Inc. www.FormsWorkFlow.com