COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ESTATE OF , DECEASED CASE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CERTIFICATE OF SERVICE AND NOTICE OF CITATION TO SURVIVING SPOUSE TO EXERCISE ELECTIVE RIGHTS [R.C. 2106.02]THE PEOPLE OF THE STATE OF NEW YORK TOThis is to certify that a Citation to Surviving Spouse to Exercise Elective Rights and a Summary of General Rights of Surviving Spouse were mailed to the surviving spouse by certified mail, and a copy of this Certificate mailed to the administrator, executor, or the attorney for the administrator or executor, by ordinary mail, on this day of , .GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,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 roomYour 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)Judge Jack R. Puffenberger By: Deputy ClerkAttorney(s) forOffice and P.O. Address�ftu9/5V-Telephone No.: Facsimile No.: E-Mail Address:FORM 8.4 CERTIFICATE OF SERVICE AND NOTICE OF CITATION TO SURVIVING SPOUSE TO EXERCISE ELECTIVE RIGHTSMobile Tel. No.:1/1/02American LegalNet, Inc. www.USCourtForms.com