PROBATE COURT OF SHELBY COUNTY, OHIO WILLIAM R. ZIMMERMAN, JUDGE ESTATE OF , DECEASED CASE NO. APPLICATION FOR FAMILY ALLOWANCE [R.C. 2106.13] The fiduciary states that there is [ ] a surviving spouse and no minor children of the decedent who are not the children of the surviving spouse; [ ] no surviving spouse and one minor child of the decedent; that the surviving spouse or minor child is entitled to receive in money or property the sum of [ ] $25,000.00, if the decedent died prior to March 18, 1999 or [ ] $40,000, if the decedent died on or after March 18, 1999, as an allowance for support, and the fiduciary hereby moves the Court to allow the surviving spouse or minor child the following items. Description Appraised Value Second automobile selected pursuant to R.C. 2106.18 DO NOT USE THIS FORM IF THERE ARE MINOR CHILDREN OF THE DECEDENT WHO ARE NOT THE CHILDREN OF THE SURVIVING SPOUSE, OR IF THERE IS NO SURVIVING SPOUSE AND MORE THAN ONE MINOR CHILD. USE FORM 7.2 FIDUCIARY ENTRY The Court finds that there is [ ] a surviving spouse and no minor children of the decedent who are not the children of the surviving spouse; [ ] no surviving spouse and one minor child of the decedent; who is entitled to receive [ ] $25,000.00 or [ ] $40,000.00 in money or property as an allowance for support. Therefore it is ORDERED that the property requested in the foregoing application be transferred to the person described in said application. The Court further orders that the fiduciary, if not the surviving spouse, serve a copy of this Entry upon all interested persons within seven (7) days. William R. Zimmerman, Probate Judge FORM 7.1 - APPLICATION FOR FAMILY ALLOWANCE 8/02/02 American LegalNet, Inc. www.FormsWorkflow.com