PROBATE COURT OF BUTLER COUNTY, OHIOESTATE OF, DECEASEDCASE NO.REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMSPursuant to Entry filed,, the proceeds have been paid as shown belowand on the accompanying vouchers. 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:$Total payments to beneficiaries$-0-BalanceThe fiduciary states that there are no other assets remaining in the estate. The fiduciary states that there are assets remaining in the estate.Attorney for FiduciaryFiduciaryAttorney Registration No.4/97FORM 14.3 -REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMS2001 © American LegalNet, Inc.ENTRYThe 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.DatePROBATE JUDGE2001 © American LegalNet, Inc.
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