PROBATE COURT OF COUNTY, OHIO _, JUDGE ESTATE OF CASE NO. , DECEASED CONTINUATION INSOLVENCY SCHEDULE OF CLAIMS [R.C. 2117.15, 2117.17, 2117.25] Page _ of Pages [Note: Include a subtotal following each payment class and a grand total for all payment classes.] Name and Address of Claimant Payment Class Amount Claimed Estimated Payment Claim Rejected: Y/N 1. (1) Comments (Refer to Claim Number) Fiduciary FORM 24.5 - CONTINUATION SCHEDULE OF CLAIMS Effective Date: January 1, 2012 American LegalNet, Inc. www.FormsWorkFlow.com