COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGECalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF THE DISINTERMENT OF: , DECEASED CASE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .APPLICATION TO OPPOSE DISINTERMENT [R.C. §§ 517.23]THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableThe Applicant states that this Application is made pursuant to Chapter 517 of the Ohio Revised Code, to oppose having the remains of the above named decedent disinterred by Court Order. The Decedent's remains are currently located in County, Ohio. Applicant further states that the following information is true: 1.,located at County ofApplicant is an interested person of sound mind who is at least eighteen years old. 2.o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomApplicant's relationship to decedent is . 3.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Applicant . did . did not assume the financial responsibility for funeral/burial expenses. If so, please attach a copy of the paid funeral bill, etc. 4., one of the Justices of theApplicant states that the disinterment . is against . is not against, decedent's religious beliefs. 5.Court in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forAttached is a Form 1.0 listing the surviving spouse (if any) and all persons who would have been entitled to inherit from the decedent as next of kin under Revised Code Chapter 2105, as well as their complete addresses; if the decedent had a Last Will, Form 1.0 must list the surviving spouse (if any) and all legatees and devisees named in the Will as well as their addresses. 6.Notice will be given to all persons listed on Form 1.0 by certified mail as required by Chapter 517. Applicant will file an Affidavit of Service indicating proper service. If applicable, Applicant will file an Affidavit of Non-Notification specifying any persons who were not given notice and the reasons for not giving notice.Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:«ejt411Jm-Mobile Tel. No.:PAGE 1 OF FORM LCPC DIS300IAmerican LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OFCASE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.7.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Applicant states that decedent . did . did not, die of a contagious disease, or if so, a permit by the Board of Health pursuant to R.C. §§ 517.23 (B) is attached hereto. 8.Applicant swears that this information is true and asks that the matter be set for hearing before this Court.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Attorney for ApplicantApplicant THE PEOPLE OF THE STATE OF NEW YORK TO Typed or Printed NameTyped or Printed Name AddressAddress GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable Phone Number (include area code),Phone Number (include area code)located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomSworn to and subscribed in my presence this day of 20 . Notary PublicYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comPAGE 2 OF FORM LCPC DIS300I