Lorain County Probate Court Judge James T. Walther ESTATE OF ________________________________________________________, DECEASED CASE NO. _________________________ CERTIFICATE OF TERMINATION [R.C. 2109.30] I certify I am the executor or administrator and the sole legatee, devisee or heir. I further certify: (1) all debts and claims presented to the estate have been paid in full or settled finally; (2) an estate tax return, if required under Chapter 5731 of the Revised Code, has been filed, and any estate tax due under that chapter has been paid; (3) all attorney fees have been [check one] waived by counsel of record, paid to counsel of record in the amount of $ ____________________; (4) all fiduciary fees have been [check one] waived by the fiduciary; paid to the fiduciary in the amount of $ ___________________; (5) all assets remaining after completion of the activities described above have been distributed to myself as the sole legatee, devisee or heir. ___________________________________ Attorney for Fiduciary ________________________________________ Fiduciary Attorney Registration No. ______________ ENTRY Based upon the above certification it is ordered that the fiduciary and surety, if any, are discharged. ____________________________________ Judge FORM 13.6 - CERTIFICATE OF TERMINATION 3/1/96 American LegalNet, Inc. www.FormsWorkFlow.com