1 PROBATE COURT OF CUYAHOGA county , OHIOA nthony J. Russo, Presiding JudgeLaura J. Gallagher, JudgeESTATE OF _____, DECEASEDCASE NUMBER _____ FIDUCIARY'S ACCOUNT( , and )[Executors and Administrators]The fiduciary offers the account given below and on the attached itemized statement of receipts and disbursements. The fiduciarystates that the account is correct, and asks that it be approved and settled.[Check one of the following]9 This is a partial account. A statement of the assets remaining in the fiduciary s hands is This is a final account. A statement of the assets remaining in the fiduciary s hands for distribution to the beneficiaries is This is an account of distribution and the fiduciary asks to be discharged upon its approval and This is a final and distributive account and the fiduciary asks to be discharged upon its approval and This is a supplemental final account.[Complete if this is a partial account, or if one or more accounts have previously been filed in the estate] The period of thisaccount is from_____ to _____[Complete if applicable] Accounts previously filed in the estate, the accounting periods, and the fiduciary and attorney fees paidfor each period, are as follows:Date FiledAccounting PeriodFiduciaryAttorneyFees PaidFees Paid$$ (K) states: The distributee may be liable to the estate up to the value of the distribution and may be required to returnall or any part of the value of the distribution if a valid claim is subsequently made against the estate within the time permittedunder this section.
2 (C) states: The rights of any person within a pecuniary interest in the estate are not barred by approval of an accountpursuant to division (A) and (B) of this section. These rights may be barred following a hearing on the account pursuant tosection of the Revised - FIDUCIARY'S ACCOUNT01/02 CASE NUMBER _____This account is recapitulated as follows:RECEIPTSP ersonal property not sold .. $_____Proceeds from sale of personal property .. _____Real property not sold .. _____Proceeds from sale of real estate .._____Income .._____Other receipts .. _____Total receipts ..$_____DISBURSEMENTSF iduciary fees [this accounting period] .. $_____Attorney fees [this accounting period] .._____Other administration costs and expenses .._____Debts and claims against estate .. _____Ohio and federal estate taxes .. _____Personal property distributed in kind .. _____Real property transferred .. _____Other distributions to beneficiaries .. _____Other disbursements.
3 _____Total disbursements .. $ _____BALANCE REMAINING IN FIDUCIARY S HANDS .. $_____ _____ AttorneyFiduciary_____ _____ Registration NumberDate ENTRY SETTING HEARINGThe COURT sets _____ at _____ o clock ____. M. as the date and time for hearingthe above _____ DateProbate Judge PROBATE COURT OF CUYAHOGA county , OHIOA nthony J. Russo, Presiding JudgeLaura J. Gallagher, JudgeESTATE OF _____, DECEASEDCASE NUMBER _____ RECEIPTS AND DISBURSEMENTS[Attach to fiduciary s account]Page _____ of _____ pagesFollowing is an itemized statement of receipts and disbursements by the fiduciary in the administration of his orValue $$Form - RECEIPTS AND DISBURSEMENTSPage _____ of _____ItemVoucherValue orValue $$_____Fiduciary PROBATE COURT OF CUYAHOGA county , OHIOA nthony J. Russo, Presiding JudgeLaura J. Gallagher, JudgeESTATE OF _____, DECEASEDCASE NUMBER _____ ASSETS REMAINING IN FIDUCIARY S HANDS[ATTACH TO PARTIAL OR FINAL FIDUCIARY S ACCOUNT]Page _____ of _____ pagesThe estate assets remaining in the fiduciary s hands are recapitulated as follows:Tangible personal property.
4 $_____Intangible personal property .. $_____Total personal property ..$_____Real Estate ..$_____Total assets remaining in fiduciary s hands .. $ Following is an itemized statement of estate assets remaining in the fiduciary s orValue $$Form - ASSETS REMAINING IN FIDUCIARY S HANDSPage _____ of _____ pagesItemVoucherValue orValue $$_____Fiduciary PROBATE COURT OF CUYAHOGA county , OHIOA nthony J. Russo, Presiding JudgeLaura J. Gallagher, JudgeESTATE OF _____, DECEASEDCASE NO. _____CERTIFICATE OF SERVICE OF ACCOUNTTO HEIRS OR BENEFICIARIES[ ]This is to certify that a true and accurate copy of the _____Type of accountaccount was served _____ upon all beneficiaries of the estate except:Date 9 The following heir or beneficiary whose address is unknown: _____ 9 The following beneficiary of a specific bequest or devise who has received his or herdistribution and for which a receipt has been filed or exhibited with the COURT : _____AttorneyFiduciaryAttorney Registration No.
5 _____FORM - CERTIFICATE OF SERVICE OF ACCOUNT TO HEIRS OR - WAIVER OF NOTICE AND CONSENT TO ACCOUNT (03/15/2016) PROBATE COURT OF CUYAHOGA county , ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge ESTATE OF , DECEASED CASE NUMBER WAIVER OF NOTICE OF HEARING AND CONSENT TO ACCOUNT The undersigned, being an heir at law or beneficiary under the Will of the decedent, hereby acknowledges receipt of a copy of the account, waives notice of the approval of hearing, and consents to the account in its entirety, including the attorney fee in the amount $ . Signature Date