IN THE WARREN COUNTY, OHIO COMMON PLEAS COURT PROBATE DIVISION IN THE MATTER WRONGFUL DEATH TRUST TESTAMENTARY TRUST SPECIAL NEEDS TRUST OTHER OF: _________________________________________________________, Deceased, Grantor for the Benefit of: _______________________________________________________________ CASE NO. _______________________ APPLICATION FOR APPOINTMENT OF TRUSTEE ____________________________________ and_____________________________________ a resident(s) of ______________________________, hereby makes application to be appointed Trustee(s) of the: Wrongful Death Trust fbo _____________________________________ as the result of the death of ____________________________________ Estate Case No.__________ Testamentary Trust created by Item ______________ of the Last Will and Testament of ____________________________________, deceased. Estate Case No. __________ Special Needs Trust created by ______________________________on ____________ Other _________________________________________________________________ A copy of the Will or Trust Agreement is attached Applicant states that the estimated property of said trust estate, is as follows: Personal Property Real Property Annual Rentals Other Annual Income Total and further states that $ _______________________ $ _______________________ $ _______________________ $ _______________________ $ _______________________ Bond is dispensed with by the instrument; Bond is dispensed with by law (100% Custodial); Bond in the sum of $ _____________________ is attached. Page 1 of 2 WCPC 50.0 Eff. 04/04/11 American LegalNet, Inc. www.FormsWorkFlow.com ___________________________________ Attorney for Applicant ___________________________________ Typed Name of Attorney for Applicant ___________________________________ Address ___________________________________ City, State, Zip ___________________________________ Phone No. (including Area Code) ___________________________________ Attorney Registration No. ____________________________________ Applicant ____________________________________ Typed Name of First Applicant ____________________________________ Typed Name of Second Applicant ____________________________________ Address ___________________________________ City, State, Zip ___________________________________ Phone No. [Include Area Code] Page 2 of 2 WCPC 50.0 Eff. 04/04/11 American LegalNet, Inc. www.FormsWorkFlow.com