MARK J. BARTOLOTTA, JUDGE PROBATE COURT OF LAKE COUNTY, OHIO ESTATE OF ___________________________________________________________, DECEASED CASE NO. ______________________ SURVIVING SPOUSE, CHILDREN, NEXT OF KIN, LEGATEES AND DEVISEES [R.C. 2105.06, 2106.13, AND 2107.19] [Use with those applications or filings requiring some or all of the information in this form, for notice or other purposes. Update as required.] The following are decedent's known surviving spouse, children, and the lineal descendants of deceased children. If none, the following are decedent's next of kin who are or would be entitled to inherit under the statutes of descent and distribution. __________________________________________________________________________________ Name Residence Relationship Birthdate Address to Decedent of Minor Surviving Spouse __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ [Check whichever of the following is applicable] The surviving spouse is the natural or adoptive parent of all of the decedent's children. The surviving spouse is the natural or adoptive parent of at least one, but not all, of the decedent's children. The surviving spouse is not the natural or adoptive parent of any of the decedent's children. There are minor children of the decedent who are not the children of the surviving spouse. There are minor children of the decedent and no surviving spouse. FORM 1.0-SURVIVING SPOUSE, CHILDREN, NEXT OF KIN, LEGATEES, AND DEVISEES American LegalNet, Inc. www.FormsWorkFlow.com [Side 2 of Form 1.0] CASE NO.________________ The following are the vested beneficiaries named in the decedent's will: __________________________________________________________________________________ Name Residence Birthdate Address of Minor __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ [Check whichever of the following is applicable] The will contains a charitable trust or a bequest or devise to a charitable trust, subject to R.C. 109.23 to 109.41. The will is not subject to R.C. 109.23 to 109.41 relating to charitable trusts. __________________________ Date __________________________________ Applicant (or give other title) __________________________________ Print Reset American LegalNet, Inc. www.FormsWorkFlow.com