PROBATE COURT OF MONTGOMERY COUNTY ALICE O. McCOLLUM, JUDGE ESTATE OF __________________________________________________, DECEASED CASE NO. _______________________ INVENTORY AND APPRAISAL [R.C. 2115.02 and 2115.09] To the knowledge of the fiduciary the attached schedule of assets in decedent's estate is complete. The fiduciary determined the value of those assets whose values were readily ascertainable and which were not appraised by the appraiser, and that such values are correct. The estate is recapitulated as follows: Tangible personal property........................................................................ ........$___________________ Intangible personal property...............................................................................$___________________ Real property..................................................................................................$___________________ Total.............................................................................................................$___________________ value $_________________ First automobile transferred to surviving spouse under R.C. 2106.18 Second automobile transferred to surviving spouse under R.C. 2106.18 value $_________________ Total value [not to exceed $40,000.00].......................................................$_________________ Insofar as it can be ascertained, an Ohio Estate Tax Return will will not be filed. The fiduciary is also the surviving spouse of the decedent and waives notice of the taking of the inventory. ___________________________________________ Attorney Attorney Registration No. ______________________ ______________________________________ Fiduciary APPRAISER'S CERTIFICATE The undersigned appraiser agrees to act as appraiser of decedent's estate and to appraise the property exhibited truly, honestly, impartially, and to the best of the appraiser's knowledge and ability. The appraiser further says that those assets whose values were not readily ascertainable are indicated on the attached schedule by a check in the "Appraised" column opposite each such item, and that such values are correct. ________________________________________ Appraiser FORM 6.0 � INVENTORY AND APPRAISAL 12/01/2002 American LegalNet, Inc. www.FormsWorkFlow.com (Reverse of Form 6.0) CASE NO. _______________________ WAIVER OF NOTICE OF TAKING OF INVENTORY [R.C. 2115.04] The undersigned surviving spouse hereby waives notice of the time and place of taking the inventory of decedent's estate. _______________________________________ Surviving Spouse WAIVER OF NOTICE OF HEARING ON INVENTORY [Use when notice is required by the Court or deemed necessary by the fiduciary] The undersigned, who are interested in the estate, waive notice of the hearing on the inventory. ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ENTRY SETTING HEARING The Court sets _____________________________________ at ____________ o'clock _____.M., as the date and time for hearing the inventory of decedent's estate. ___________________________________________ Date ________________________________________ Probate Judge American LegalNet, Inc. www.FormsWorkFlow.com