PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE ESTATE OF __________________________________________________, DECEASED CASE NO.______________________________ JUDGMENT ENTRY OF INSOLVENCY [R.C. 2117.15, 2117.17, 2117.25] This matter was heard on the _____ day of ______________________________, 20_____ on the Representation of Insolvency and Insolvency Schedule of Claims. The Court finds that notice was properly given to all creditors, claimants and other interested persons. The Court finds: that there were no exceptions filed as to the allowance or classification of any specific claim, or that any exceptions filed were addressed and resolved by the Court. The Court finds: that the fiduciary acted properly in classifying, allowing or rejecting claims on the Insolvency Schedule of Claims. that the Insolvency Schedule of Claims is amended as follows: __________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ The Court finds that the claims against the estate exceed the assets of the estate, and that the estate is insolvent. it is Ordered that the fiduciary shall pay the claims in the order and in the amount as proposed. it is Ordered that the fiduciary shall pay the claims in the order and in the amount as proposed, except as follows: __________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ FORM 24.6 – JUDGMENT ENTRY OF INSOLVENCY Effective Date: January 1, 2012 American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. ___________________ It is Ordered: that all claims in Class ______are to be paid in full, that all claims in Class _______ are to be paid pro rata at ______% per attached computation, and that all claims below Class ______ are disallowed in that there are no funds available. It is Ordered that the fiduciary shall file a Final and Distributive Account within thirty (30) days of this Order. It is Ordered that the fiduciary shall file a Certificate of Termination within thirty (30) days of this Order. ___________________________________ ALICE O. McCOLLUM, PROBATE JUDGE FORM 24.6 – JUDGMENT ENTRY OF INSOLVENCY PAGE 2 Effective Date: January 1, 2012 American LegalNet, Inc. www.FormsWorkFlow.com