PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE IN THE MATTER OF: CASE NO.: APPLICATION TO DISPENSE WITH THE APPOINTMENT OF A GUARDIAN [R.C. 2111.05] INSTRUCTIONS: Provide the requested information and sign on the Applicant's Signature blank. I am a resident of Montgomery County, Ohio. I am requesting an order to dispense with the appointment of a guardian of the estate of a minor, pursuant to R.C. 2111.05. The minor's name is: The minor's address is: The minor's date of birth is: The minor's property is less than $25,000, and consists of: I am requesting that the Court order that the minor's property be: Delivered to the minor's legal custodian(s). I have filed a Statement in Support, M.C. Form 16.0B. Delivered to the minor's parent(s). I have filed a Statement in Support, M.C. Form 16.0B. Deposited in a financial institution. I have filed an Acknowledgment of Responsibility, M.C. Form 16.0C. I have also filed a Next of Kin of Proposed Ward, Form 15.0, with this application. __________________________________________ Attorney's Signature __________________________________________ Attorney's Printed Name __________________________________________ Address __________________________________________ City State Zip Code __________________________________________ Telephone Number __________________________________________ Attorney Registration Number __________________________________________ Applicant's Signature __________________________________________ Applicant's Printed Name __________________________________________ Address __________________________________________ City State Zip Code __________________________________________ Telephone Number __________________________________________ Applicant's Email Address American LegalNet, Inc. www.FormsWorkFlow.com M.C. FORM 16.0A ­ APPLICATION TO DISPENSE WITH THE APPOINTMENT OF A GUARDIAN 6/1/16