Report Of Distribution Of Wrongful Death And Survival Claims {14.3} | Pdf Fpdf Doc Docx | Ohio

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Report Of Distribution Of Wrongful Death And Survival Claims {14.3} | Pdf Fpdf Doc Docx | Ohio

Report Of Distribution Of Wrongful Death And Survival Claims {14.3}

This is a Ohio form that can be used for Wrongful Death within County (Court Of Common Pleas), Lucas, Probate.

Alternate TextLast updated: 5/23/2006

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<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGECalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ESTATE OF , DECEASED CASE NO. REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pursuant to Entry filed , 20 the proceeds have been paid as shown below and on the accompanying vouchers. Gross ProceedsTHE PEOPLE OF THE STATE OF NEW YORK TO$ Funeral and burial expenses$ Fiduciary fees to$ Reimbursement of case expenses To$ Attorney fees to$ Survival claim to the estateGREETINGS:$ Total DeductionsWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable$,located at County ofNet Proceeds$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 roomNet Proceeds to Beneficiaries: To:$ To:$ To:$ To: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 $50 and all damages sustained as a result of your failure to comply.$ To:$ To:$ To:$ Total Payments to Beneficiaries, one of the Justices of the$Court in Witness, Honorableday of, 20 County,$Balance(Attorney must sign above and type name below). The fiduciary states that there are no other assets remaining in the estate. . The fiduciary states that there are assets remaining in the estate.Attorney(s) forOffice and P.O. AddressAttorney for FiduciaryFiduciaryAttorney Registration No.Telephone No.: Facsimile No.: E-Mail Address:«xe25/49-Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comPAGE 1 OF FORM 14.3 REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMSCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.CASE NO. Calendar No.JUDICIAL SUBPOENA«xe25/4kfa-Plaintiff(s) -against-Defendant(s)ENTRYThe above report of distribution of the proceeds is hereby approved. . There being no further assets to administer, the fiduciary and surety, if any, are discharged.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .DateJudge Jack R. PuffenbergerTHE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'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 roomYour 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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:PAGE 2 OF FORM 14.3 REPORT OF DISTRIBUTION OF WRONGFUL DEATH AND SURVIVAL CLAIMSAmerican LegalNet, Inc. www.USCourtForms.com</document>

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