PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE IN THE MATTER OF THE: CASE NO. ____________________ WRONGFUL DEATH TRUST for the benefit of: _______________________________________ INTER VIVOS TRUST for the benefit of: _____________________________________________ TESTAMENTARY TRUST for the benefit of: _________________________________ _________ SPECIAL NEEDS TRUST for the benefit of: __________________________________________ TRUSTEES BOND Amount of bond $____________________________________ Amount of Additional bond $____________________________ The undersigned principal and sureties are obligated to the State of Ohio in the above amount, for payment of which we bind ourselves and our successors, heirs, executors, and administrators, jointly and severally. The principal has accepted in writing the duties of the fiduciary in the trust estate including those imposed by law and such additional duties as may be required by the Court. This obligation is void if the principal performs such duties as required. This obligation remains in force if the principal fails to perform such duties, or performs them tardily, negligently, or improperly, or if the principal misuses or misappropriates estate assets or improperly converts them to his own use or the use of another. A copy of the Power of Attorney for any party for the surety is attached. [Check if personal sureties are involved]. The sureties certify that each of them owns real estate in this county, with a reasonable net value as stated below. ________________________ ________ _________ ______________________ Date P rincipal ________________________________________________ ______________________________________________ Surety S urety by______________________________________________ ______________________________________________ Attorney in Fact Attorney in Fact ________________________________________________ ______________________________________________ Typed or Printed Name Typed or Printed Name ________________________________________________ ______________________________________________ Address A ddress ________________________________________________ _______________________________________________ City, State, Zip Code City, State, Zip Code ________________________________________________ _______________________________________________ Telephone Number (including area code) Telephone Number (including area code) Net value of real estate Net value of real estate owned in this county owned in this county $____________________________________________________ $___________________________________________________ M.C. FORM 25.2A - TRUSTEES BOND American LegalNet, Inc. www.USCourtForms.com