MARK J. BARTOLOTTA, JUDGE PROBATE COURT OF LAKE COUNTY, OHIO IN THE MATTER OF Wrongful Death Trust Testamentary Trust Special Needs Trust OF ___________________________________ Case No. _____________________Docket___________________Page___________________ APPLICATION FOR APPOINTMENT OF TESTAMENTARY TRUSTEE [R.C. 2109.02] The undersigned hereby make(s) application to be appointed Trustee(s) of the: Wrongful Death Trust fbo_________________________________________________ as the result of the death ___________________________________, Estate Case No.___________ Testamentary Trust created by Item _____________ of the Last Will and Testament of ___________________________________, deceased. Estate Case No. ______________ Special Needs Trust created by _______________________ on ___________________ A copy of the Will or Trust Agreement is attached. Applicant state(s) that the estimated property of said trust estate, is as follows: Personal Property $_____________________ Real Estate $_____________________ Annual Rentals $_____________________ TOTAL $_____________________ and further state(s) that Bond is dispensed with by the instrument; Bond is dispensed with by law (100% Custodial); Bond is in the sum of $ _________________ is attached. ______________________________ Attorney for Applicant ______________________________ Applicant Typed Name of First Applicant ______________________________ Typed Name of Attorney for Applicant Address ______________________________ ______________________________ Typed Name of Second Applicant ______________________________ ______________________________ City, State, Zip Address ______________________________ ______________________________ City, State, Zip ______________________________ Phone Number (Include area code) Attorney Registration Number ______________________________ ______________________________ Phone Number (include area code) American LegalNet, Inc. www.FormsWorkFlow.com