Assets And Liabilities Of Estate To Be Relieved From Administration

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PROBATE COURT OF ________________ COUNTY, OHIO
ESTATE OF ______________________________________________________________, DECEASED
CASE NO. _______________________
ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION
Following is a summary statement of the character and value of the assets in decedent's estate [Insert a check in the
"Appraised" column opposite an item if it was valued by the appraiser. Leave blank if the readily ascertainable value of the item
was determined by applicant. Use extra sheets if necessary.]
Automobiles distributed to surviving spouse by affidavit
Value
First automobile selected by surviving spouse under R.C. 2106.18
[Omit value when computing total assets]
Appraised value $
XXXX
- - - - - - - - - -
Second automobile selected by surviving spouse under R.C. 2106.18
[Omit value when computing total assets]
Appraised value $
XXXX
- - - - - - - - - -
Total value [not to exceed $40,000.00]
$
XXXX
Character of asset
Appraised
Value
Real Estate, described in accompanying
Certificate of Transfer No.
$
Other assets
$
Total Assets
$
FORM 5.1 - ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION
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