PROBATE COURT OF SHELBY COUNTY, OHIO TRUST OF FOR THE BENEFIT OF CASE NO. TRUSTEE'S BOND Amount of 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 trustee pursuant to: () () () said decedent's Will (and Codicil(s)) wrongful death settlement trust [R.C. 2125.03] special needs trust [R.C. 2111.50(B)(3)] Said duties include the following: 1. 2. 3. Make and return to the Court, on oath, as provided by and within the time required by law a true inventory of the real and personal property belonging to the Trust; Administer and distribute according to law and the Trust all the real and personal property belonging to the Trust; Render upon oath a just and true account of the administration at the time or times required by the Court or the law; AND in all matters, faithfully and honestly discharge the duties of said office, and comply with all conditions imposed by law. 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. [Check if personal sureties are involved] county, with a reasonable net value as stated below. Date Surety By Attorney in Fact Typed or Printed Name Address Net value of real estate owned in this county $ Principal Surety By Attorney in Fact Typed or Printed Name Address Net value of real estate owned in this county $ H.C. FORM 24.3 - TRUSTEE'S BOND American LegalNet, Inc. www.FormsWorkFlow.com The sureties certify that each of them owns real estate in this 02/10/03