PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE IN THE MATTER OF CASE NO. __________________________________ __________________________________ PETITION FOR DESIGNATION OF SUCCESSOR CUSTODIAN R.C. 5814.07(F) Pursuant to the Ohio Transfers to Minors Act, the property described in Exhibit A, attached, is custodial property held for ______________________________, a minor. MINOR'S INFORMATION The minor resides at: ____________________, ____________________, _____, __________. The minor's natural parents are: ______________________________ and _____________________________. APPLICANT'S INFORMATION The applicant is: ___ ___ ___ ___ ___ The donor or transferor; The legal representative of the donor or the transferor; The legal representative of the custodian; A member of the minor's family and eighteen years of age or older; The minor and fourteen years of age or older. PETITION The applicant represents that: ___ The designated successor custodian, ______________________________, is ineligible, has renounced, or is deceased; ___ The custodian died without designating a successor custodian and there is no legal representative of the custodian's estate. 11/20/2015 M.C. FORM MSC 104C PETITION FOR DESIGNATION OF SUCCESSOR CUSTODIAN American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. __________________________________ The applicant further represents that a legal guardian has not been appointed for the minor and a successor custodian must be designated for the property described in Exhibit A. The applicant petitions this Court to make the foregoing designation. The consents of the minor's natural parents are ___ / are not ___ attached as exhibits to this petition. If the consents are not attached, the petition must be set for hearing and notice of the petition and hearing must be served upon the minor's natural parents. ________________________________ Attorney Signature ________________________________ Attorney Name ________________________________ Address ________________________________ City State Zip Code ________________________________ Telephone Number ________________________________ Attorney Registration No. ________________________________ Applicant Signature ________________________________ Applicant Name ________________________________ Address ________________________________ City State Zip Code ________________________________ Telephone Number 11/20/2015 M.C. FORM MSC 104C PETITION FOR DESIGNATION OF SUCCESSOR CUSTODIAN American LegalNet, Inc. www.FormsWorkFlow.com