PROBATE COURT OF TRUMBULL COUNTY, OHIO JAMES A. FREDERICKA, JUDGE ESTATE OF _________________________________________________________, DECEASED CASE NO. _____________________ INVENTORY AND APPRAISAL [R.C. 2115.02] To the knowledge of the fiduciary the attached schedule of assets in decedent's estate is complete. The fiduciary determined the value of those assets whose values were readily ascertainable and which were not appraised by the appraiser, and that such values are correct. The estate is recapitulated as follows: Tangible personal property Intangible personal property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$______________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$______________ Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$______________ Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________ First automobile transferred to surviving spouse under R.C. 2106.18 under R.C. 2106.18 Second automobile transferred to surviving spouse . . . . . . . . . . . . . . . . . . . . . appraised value $__________________ . . . . . . . . . . . . . . . . . . . . . appraised value $__________________ Total value (not to exceed $40,000.00). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________ [Check if applicable] The surviving spouse is the sole legatee and devisee under decednt's will, and has not manifested an intention to take against it. It is therefore unnecessary to cite the surviving spouse to make an election. _____________________________________ Attorney Attorney Registration No._____________________ __________________________________ Fiduciary APPRAISER'S CERTIFICATE The undersigned appraiser agrees to act as appraiser of decedent's estate, and to appraise the property exhibited truly, honestly, impartially, and to the best of the appraiser's knowledge and ability. The appraiser further says that those assets whose values were not readily ascertainable are indicated on the attached schedule by a check in the "Appraised" column opposite each such item, and that such values are correct. ______________________________________________ Appraiser 4/1/97 FORM 6.0-INVENTORY AND APPRAISAL American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. _______________________ WAIVER OF NOTICE OF TAKING OF INVENTORY [R.C. 2115.04] The undersigned surviving spouse hereby waives notice of the time and place of taking the inventory of decedent's estate. ____________________________________ Surviving Spouse WAIVER OF NOTICE OF HEARING ON INVENTORY (Use when notice is required by the Court or deemed necessary by the fiduciary) The undersigned, who are interested in the estate, waive notice of the hearing on the inventory. ENTRY SETTING HEARING The Court sets _____________________________at ______________o'clock____.M., as the date and time for hearing the inventory of decedent's estate. _____________________________________ Date ________________________________ JAMES A. FREDERICKA Judge FORM 6.0-INVENTORY AND APPRAISAL 4/1/97 American LegalNet, Inc. www.FormsWorkFlow.com