PROBATE COURT OF ________________ COUNTY, OHIO ESTATE OF: ____________________________________________________________________ CASE NO. _____________________ CERTIFICATE OF SERVICE AND NOTICE OF CITATION TO SURVIVING SPOUSE TO EXERCISE ELECTIVE RIGHTS [R.C. 2106.02] This is to certify that a Citation to Surviving Spouse to Exercise Elective Rights and a Summary of General Rights of Surviving Spouse were mailed to the surviving spouse by certified mail, and a copy of this Certificate mailed to the administrator, executor, or the attorney for the administrator or executor, by ordinary mail, on this _________________ day of _______________________, _____________. Probate Judge By: _____________________________________ Deputy Clerk Print Form FORM 8.4 - CERTIFICATE OF SERVICE AND NOTICE OF CITATION TO SURVIVING SPOUSE TO EXERCISE ELECTIVE RIGHTS 12/01/2002 American LegalNet, Inc. www.FormsWorkFlow.com