Report Of Distribution Of Wrongful Death And Survival Claims
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Report Of Distribution Of Wrongful Death And Survival Claims Form. This is a Ohio form and can be use in Wood County (Court Of Common Pleas).
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Tags: Report Of Distribution Of Wrongful Death And Survival Claims, 14.3, Ohio County (Court Of Common Pleas), Wood
PROBATE COURT OF WOOD COUNTY, OHIO
David E. Woessner, Judge
Estate of:_________________________________________________________________, Deceased
Case No. _____________________________
Date:______________________
REPORT OF DISTRIBUTION OF
WRONGFUL DEATH AND SURVIVAL CLAIMS
Pursuant to Entry filed
accompanying vouchers.
,
, the proceeds have been paid as shown below and on the
Gross Proceeds
$
Funeral and burial expenses
$
Fiduciary fees to
$
Reimbursement of case expenses to
$
Attorney fees to
$
Survival claim to the estate
$
Total Deductions
$
Net Proceeds
$
Net proceeds to beneficiaries:
To:
$
To:
$
To:
$
To:
$
To:
$
To:
$
To:
$
Total payments to beneficiaries
Balance
$
c
The fiduciary states that there are no other assets remaining in the estate.
c
The fiduciary states that there are assets remaining in the estate.
___
Attorney for Fiduciary
Fiduciary
Attorney Registration No.
FORM 14.3 - REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMS
Crensch$\forms\14.3
7/26/01
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ENTRY
The above report of the distribution of the proceeds is hereby approved.
There being no further assets to administer, the fiduciary and surety, if any, are discharged.
Date Journalized
David E. Woessner, Probate Judge
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