PROBATE COURT OF SHELBY COUNTY, OHIO CONSERVATORSHIP OF CASE NO. CONSERVATOR'S BOND (R.C. 2109.04(A)(1)) Amount of this bond $ The undersigned principal, and sureties if any, 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 fiduciary in conservatee's 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. The sureties certify that each of them [Check if personal sureties are involved.] owns real estate in this county, with a reasonable net value as stated below. Date Principal Surety by Attorney in Fact Surety by Attorney in Fact Typed or Printed Name Typed or Printed Name Address Address Net value of real estate owned in this county $ Net value of real estate owned in this county $ American LegalNet, Inc. www.FormsWorkFlow.com H.C. FORM 20.3 - CONSERVATOR'S BOND 02/10/03