IN THE PROBATE COURT OF MAHONING COUNTY, OHIO JUDGE MARK BELINKY IN THE MATTER OF ______________________________, DECEASED CASE NO.: __________________ DATE OF DEATH: __________________________ APPLICATION FOR AUTHORITY TO INVENTORY THE CONTENTS OF A SAFE DEPOSIT BOX Now comes the Applicant, ________________________________, and offers new proof satisfactory to the Court that the above Decedent passed away on ________________, was a resident of Mahoning County, Ohio, and a lessee of a certain Safe Deposit Box, Number ______________, with ___________________________________, as the depository/lessor thereof. Your applicant requests an Order of this Court directing that a Deputy Clerk conduct a full inventory of the contents thereof, retrieve and deliver the decedent’s Last Will and Testament to the Court, if one be found therein, and for such other purposes as may be necessary or Ordered by the Court. __________________________________ ____________________________________ Attorney for Applicant’s Signature Applicant’s Signature __________________________________ ____________________________________ Attorney for Applicant’s printed or typed name Applicant’s printed or typed name __________________________________ ____________________________________ Street Address Street Address __________________________________ ____________________________________ City, State Zip City, State, Zip __________________________________ ____________________________________ Area Code/Phone No. Area Code/Phone No. __________________________________ Attorney Registration No. ORDER FOR INVENTORY Upon application and for good cause shown, Barbara Balestrino, Martin A. Cegan or Robert Rimedio, a Deputy Clerk for this Court, is Ordered to forthwith inventory the contents of a certain Safe Deposit Box, No. ___________, with the above identified Depository, ________________________________________, standing in the name of the within Decedent who died a resident of Mahoning County, Ohio. The Clerk shall thoroughly inspect and accurately inventory the contents thereof and shall return and file a written inventory with the Court. Further and in the event the Clerk shall discover the decedent’s Last Will and Testament(s) while conducting such inventory, the Clerk shall note such fact upon the inventory and shall physically take possession of such Will and return and file the same with the Court, together with the inventory, for record only. IT IS SO ORDERED. Dated: ____________________ ______________________________ Judge/Magistrate Revised 01-15-08 American LegalNet, Inc. www.FormsWorkflow.com