PROBATE COURT OF LAKE COUNTY, OHIO TED KLAMMER, JUDGE ESTATE OF ___________________________________________________________________, DECEASED Case No. ____________________________ Docket ____________________________ Page ______________ REPORT OF NEWLY DISCOVERED ASSETS AND JUDGMENT ENTRY – ORDERS TO ADMINISTER Revised Code, Sec. 2113.69 The undersigned, __________________________ , ____________________ of the estate of ________________________________deceased, respectfully reports that certain newly discovered assets have come into_________________ hands since the filing of the original Inventory in said estate on the___________ day of_______________________ Said assets, with the estimated value of each, are as follows: Description of Assets Estimated Value Wherefore the undersigned prays for an order of the court to administer, account for, distribute such assets in like manner as if received prior to the filing of the original Inventory without being required to make an Inventory or Appraisement of the same unless ordered to do so by the Court, either on its own motion or upon the application of any interested party. Respectfully submitted, this___________ day of _____________________________________________ X____________________________________________ Fiduciary __________________________________of the estate of ______________________________________________ Deceased The State of Ohio, ___________________________________County. ______________________________________________________________________, being duly sworn, says that the foregoing report is in all respect true and correct as__________ verily believes. X__________________________________ Fiduciary Prepared by Sworn to before me and signed in my presence, this Attorney’s Name__________________ _____day of__________________________ Address _________________________ __________________________________________ Phone No._______________________ ____________________________________ American LegalNet, Inc. www.FormsWorkflow.com Notary/Deputy Clerk