PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE IN THE MATTER * CASE NO. THE ESTATE OF: * * * APPLICATION FOR DIRECTIONS ON * DISPOSITION OF UNCLAIMED FUNDS * Now comes , the (Name) (Title of Fiduciar y / Applicant)of the estate of , deceased. The fiduciary states that he/she holds the sum of $ ________________ to which is entitled as a beneficiary and that said sum has been unclaimed. [Check if Applicable]  Date of death of decedent was prior to January 1, 2002 and the sum has been unclaimed for more than six (6) months. On the ____ day of ________________________, 20____, this Court made an order of distribution in the above-entitled estate. The fiduciary / applicant asks the Court pursuant to R.C. 2113.64 to:  ORDER payment of the sum into the County Treasury  Authorize Investment of sum for the benefit of the beneficiary. Fiduciary / Applicant (Signature of Attorney of Record) (Print Attorneys Name) (Address of Attorney of Record) (Phone Number of Attorney of Record) (Supreme Court Registration Number) mdqd38/2Q- American LegalNet, Inc.American LegalNet, Inc. FORM LCPC-27.1 APPLICATION FOR DIRECT IONS ON DISPOSITION OF UNCLAIMED FUNDS www.USCourtForms.comwww.USCourtForms.com