PROBATE COURT OF SHELBY COUNTY, OHIO WILLIAM R. ZIMMERMAN, JUDGE ESTATE OF , DECEASED CASE NO. SUPPLEMENTAL APPLICATION FOR ANCILLARY ADMINISTRATION Applicant says that the decedent named in the attached application for authority to administer the estate owning property in this county died [check one of the following] having a debtor residing in this countyApplicant is a resident of Ohio. [Check one of the following three paragraphs] Applicant is the general executor named in decedent's Will, and is duly appointed, qualified and acting in that capacity in the state of An exemplified record of the grant of his letters of authority is attached. Applicant is named in decedent's Will as executor of his Ohio estate. Applicant is a resident of this county. Decedent either died intestate, or did not designate an Ohio executor or administrator in his Will. An authenticated copy of decedent's Will, duly proved in another state, is [Check if applicable] attached and offered for record. The estimated value of decedent's Ohio estate is $ Applicant FORM 4.1 - SUPPLEMENTAL APPLICATION FOR ANCILLARY ADMINISTRATION 8/02/02 American LegalNet, Inc. www.FormsWorkflow.com