IN THE PROBATE COURT OF MONTGOMERY COUNTY, OHIO IN THE MATTER OF: ________________________ (NAME OF MINOR) CASE NO. ______________________ ENTRY APPOINTING SUCCESSOR CUSTODIAN (R.C. 5814.07(G)) This matter is before this court on an application to remove the original custodian, _____________________, due to his/her death and for an order of this Court to appoint a successor custodian. This Court finds that all necessary persons have been duly notified and /or waived notice and consented to this application. This Court finds that the original custodian was named as custodian, under the Ohio Transfer to Minors Act, over the following accounts for the benefit of ________________________________, a minor: ________________________________________________________________ ________________________________________________________________ This Court further finds that the original custodian should be removed due to his/her death and that the applicant should be appointed as successor custodian of the above account(s). WHEREFORE, IT IS THE ORDER of this Court that __________________________ ______________________ is hereby appointed as successor custodian of the above account(s). SO ORDERED: ________________________________ Judge Alice O. McCollum M.C. FORM 4F - ENTRY APPOINTING SUCCESSOR CUSTODIAN American LegalNet, Inc. www.FormsWorkflow.com