COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF STARK COUNTY, OHIOJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN RE: THE ESTATE OF, DECEASEDCASE NO.SUPPLEMENT TO APPLICATION TO APPROVE SETTLEMENT AND DISTRIBUTION OF WRONGFUL DEATH AND SURVIVOR CLAIMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Attorney's Name (Plaintiff) Attorney's Name (Defendant) Age of DecedentTHE PEOPLE OF THE STATE OF NEW YORK TOAttached hereto as an Exhibit is a narrative statement of facts in accordance with Sup. R. 70(A) regarding the details of the claim.Gross settlement or jury verdict$Recapitulation of expenses:GREETINGS:Funeral & burial$WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,Last illness$located at County ofLitigation expenses$o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomFiduciary fees$Attorney fees$Net remaining$Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.The offer of settlement includes a structured settlement and the details of the structure are attached hereto as an Exhibit.[], one of the Justices of theSpecific details of structured settlement: (attach written verification)Court in Witness, Honorableday of, 20 County,Present value of structure$Lifetime value of structure$(Attorney must sign above and type name below)Guaranteed value of structure $ Immediate cash payment$Attorney(s) forName of annuity underwriterBest rating of annuity underwriterOffice and P.O. Address[ ] The proposed settlement includes a wrongful death trust. Details of the wrongful deathtrust, including a proposed Judgment Entry is attached hereto as an Exhibit.Telephone No.: Facsimile No.: E-Mail Address:DateAttorney for FiduciaryMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comSCPC FORM 14.0C -SUPPLEMENT TO APPLICATION TO APPROVE SETTLEMENT
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