PROBATE COURT OF SHELBY COUNTY, OHIO ESTATE OF CASE NO. , DECEASED REPORT OF DISTRIBUTION Now comes your duly appointed herein and submits the Report in said matter. Distribution of the assets has been made in accordance with the previous order of this Court in the following manner: DATE OF SALE OR DISTRIBUTION TO WHOM SOLD OR DISTRIBUTED DESCRIPTION PROCEEDS OR VALUE Commissioner JUDGMENT ENTRY The within Report of Distribution having been made according to law and the former order of the Court, it is ordered that the Report of Distribution is hereby approved. Probate Judge H.C. FORM 5.9 - REPORT OF DISTRIBUTION - ESTATE RELIEVED FROM ADMINISTRATION American LegalNet, Inc. www.FormsWorkFlow.com 02/10/03