PROBATE COURT OF WARREN COUNTY, OHIO ESTATE OF CASE NO. SUPPLEMENTAL APPLICATION FOR ANCILLARY ADMINISTRATION Applicant says that the decedent named in the attached application for authority to administer the estate died [check one of the following] -owning property in this county -having a debtor residing in this county. Applicant 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. [Check if applicable] -An authenticated copy of decedent's Will, duly proved in another state, is attached and offered for record. The estimated value of decedent's Ohio estate is $ , DECEASED Applicant FORM 4.1 - SUPPLEMENTAL APPLICATION FOR ANCILLARY ADMINISTRATION 7/1/77 American LegalNet, Inc. www.USCourtForms.com