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9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST 9 SPECIAL NEEDS TRUST APPLICATION FOR APPOINTMENT OF TRUSTEE Hereby make(s) application to be appointed Trustee(s) of the: 9 Wrongful Death Trust fbo as the result of the death of, Estate case no. ; 9 Special needs Trust created by on ; Month, Day, Year and states that the estimated property of said trust estate, is as follows: Personal Property... $ Real Estate... $ Annual Rentals... $ Totals... $ and states that: 9 Bond is dispensed with by the instrument; 9 Bond is dispensed with by law (100% Custodial); 9 Bond in the sum of $ is attached; Attorney for Applicant Typed or Printed Name City, State, Zip Phone Number (include Area code) Attorney Registration No. Applicant Phone Name Phone FORM 25.0 A - APPLICATION FOR APPOINTMENT OF TRUSTEE

9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST9 SPECIAL NEEDS TRUST TRUSTEE 'S ACCEPTANCE [R.C. 2109.02] I hereby accept the duties which are required of me by law, and such additional duties as are ordered by the Court. As trustee of this estate I will: 1) Make and file an inventory of the real and personal assets of the trust within 3 months after appointment, or such time as extended by the Court; 2) Deposit funds which come into my hands in a lawful depository located within this state; The trust checking accounts must provide canceled checks, as these canceled checks must be displayed when filing accounts; 3) Keep trust funds in separate trust accounts at all times during the administration of the trust; 4) Invest all funds in a lawful manner; 5) Timely pay bond premium, if any; 6) Make and file 1 st account within one (1) year following my appointment or such time as ordered by the Court; File additional accounts on at least an annual basis; Accounts require a personal appearance; Filings by mail are not accepted; 7) Timely file all tax documents as required by law; 8) Submit all filings with original signatures; In all matters with multiple fiduciaries, the signature of all fiduciaries is required; Persons who are not an attorney may not sign on behalf of an attorney; 9) Obey all orders of the Court; and 10) Immediately notify the Probate Court if I change my address. I acknowledge that I am subject to removal as trustee if I fail to perform my fiduciary duties. I acknowledge that I am subject to possible civil and criminal penalties for improper conversion of the property which I hold as fiduciary. Note ORC 2109.02 states that every fiduciary, before entering into the execution of a trust, shall receive letters of appointment from a Probate Court having jurisdiction of the subject matter of the trust. The duties of a fiduciary shall be those required by law, and such additional duties as the Court orders. Letters of appointment shall not issue until a fiduciary has executed a written acceptance of those duties, acknowledging the appointment shall not issue until a fiduciary has executed a written acceptance of those duties, acknowledging the possibility of removal for failure to perform those duties, and further being subject to possible penalties for conversion property held as a fiduciary. The written acceptance of duties may be filed with the application for appointment. Date Trustee FORM 25.1 A - FIDUCIARY'S ACCEPTANCE TRUSTEE

9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST 9 SPECIAL NEEDS TRUST Amount of bond $. TRUSTEE S BOND The undersigned principal, and sureties are obligated to the State of Ohio in the above amount, for payment of which we bind ourselves and our successors, heirs, executors, and administrators, jointly and severally. The principle has accepted in writing the duties of fiduciary in the trust estate including those imposed by law and such additional duties may be required by the Court. This obligation remains in force if the principle fails to perform such duties, or performs them tardily, negligently, or improperly, or if the principle misuses or misappropriates estate assets or improperly converts them to his own use or the use of another. [Check if personal sureties are involved.] 9 The Sureties certify that each of them owns real estate in this county, with a reasonable net value as stated below. Date Surety by Attorney in Fact Type or Printed Name City, State, Zip Code Telephone number (including area code) Net value of real estate owned in this county $ Principal Surety by Attorney in Fact Type or Printed Name City, State, Zip Code Telephone number (including area code) Net value of real estate owned in this county $ Form 25.2A - Trustee s Bond

9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST 9 SPECIAL NEEDS TRUST TRUST INVENTORY Description of Personal Estate and Value Thereof Value FORM 25.4A - TRUST INVENTORY

Description and Value of Real Estate and the Yearly Rents of Same $ Value RECAPITULATION Total Value of Personal Estate,....................................................... $ Total Value of real Estate,.......................................................... Yearly Rent of Real Estate,......................................................... Other Income.................................................................... Total $ The undersigned trustee says that the foregoing is a full inventory of the real and personal estate in the matter with the value of the same and the value of the yearly rent of said estate, according to the best of trustee s knowledge. Trustee

9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST9 SPECIAL NEEDS TRUST TRUSTEE S ACCOUNT [R.C.. 2109.30] Date 20 (Balance from previous account or inventory) Voucher No. $ $ FORM 25.5A - TRUSTEE S ACCOUNT

RECAPITULATION Total Receipts Total Disbursements $ $ Balance Remaining $ ITEMIZED STATEMENT OF ALL REMAINING FUNDS, ASSETS AND INVESTMENTS Item $ Attorney Supreme Court Registration No. Trustee City, State, Zip Code _( ) Telephone Number ENTRY SETTING HEARING AND ORDERING NOTICE The Court sets at o clock m. as the date and time for hearing the above accounting and orders notice to be given as provided by law and Rules of Civil Procedure. Date Judge

9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST 9 SPECIAL NEEDS TRUST APPLICATION FOR APPOINTMENT OF TRUSTEE Hereby make(s) application to be appointed Trustee(s) of the: 9 Wrongful Death Trust fbo as the result of the death of, Estate case no. ; 9 Special needs Trust created by on ; Month, Day, Year and states that the estimated property of said trust estate, is as follows: Personal Property... $ Real Estate... $ Annual Rentals... $ Totals... $ and states that: 9 Bond is dispensed with by the instrument; 9 Bond is dispensed with by law (100% Custodial); 9 Bond in the sum of $ is attached; Attorney for Applicant Typed or Printed Name City, State, Zip Phone Number (include Area code) Attorney Registration No. Applicant Phone Name Phone FORM 25.0 A - APPLICATION FOR APPOINTMENT OF TRUSTEE