PROBATE COURT OF ________________ COUNTY, OHIO
ESTATE OF ___________________________________________________________, DECEASED
CASE NO. _______________________
APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION
[R.C. 2113.03]
Applicant states that decedent died on ______________________________________________________
Decedent's domicile was _______________________________________________________________
Street Address
________________________________________________________________________________
City or Village, or Township if unincorporated area County
________________________________________________________________________________
Post Office State Zip Code
[Check one of the following]
Decedent's will has been admitted to probate in this Court.
To applicant's knowledge, decedent did not leave a will.
[Check one of the following]
The assets are $15,000 or less and decedent died on or after January 1, 1976.
The assets are $25,000 or less and decedent died on or after October 20, 1987.
The assets are $35,000 or less and decedent died on or after November 9, 1994.
The assets are $50,000 or less; the surviving spouse is entitled to all of the assets and the decedent died on or after
April 16, 1993.
The assets are $85,000 or less; the surviving spouse is entitled to all of the assets and the decedent died on or after
September 14, 1993.
The assets are $100,000 or less; the surviving spouse is entitled to all of the assets and the decedent died on or after
March 18, 1999.
Applicant asks that the estate be relieved from administration because the assets do not exceed the statutory limits. A
statement of the assets and liabilities of the estate is listed on the attached Form 5.1.
The decedent's surviving spouse, next of kin, legatees, and devisees known to applicant, are listed on the attached Form
1.0.
___________________________________ _____________________________________
Attorney for Applicant Applicant
___________________________________ _____________________________________
Typed or Printed Name Typed or Printed Name
___________________________________ _____________________________________
Address Address
___________________________________ _____________________________________
___________________________________ _____________________________________
Phone Number (include area code) Phone Number (include area code)
Attorney Registration No. ___________________________
FORM 5.0 - APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION
5/3/99
(Reverse of Form 5.0)
WAIVER OF NOTICE
The undersigned surviving spouse, heirs at law, legatees, devisees, and other persons entitled to notice of the filing of the
application to relieve decedent's estate from administration, waive such notice.
___________________________________ _____________________________________
___________________________________ _____________________________________
___________________________________ _____________________________________
___________________________________ _____________________________________
ENTRY SETTING HEARING AND ORDERING NOTICE
The Court sets _____________________________________________, at ___________ o'clock _______. M., as the
date and time for hearing the application to relieve decedent's estate from administration.
[Check one of the following]
All notice is dispensed with as unnecessary.
Notice by publication to interested parties is dispensed with as unnecessary. Written notice shall be given, as provided
by law and the Rules of Civil Procedure, to those persons entitled to notice, who have not waived notice.
Written notice is dispensed with as unnecessary. Notice by publication shall be given to interested parties as provided
by law and the Rules of Civil Procedure.
Written notice shall be given to those persons entitled to notice, who have not waived notice, and notice by publication
shall be given to interested parties, as provided by law and the Rules of Civil Procedure.
________________________________ _______________________________________
Date Probate Judge
FORM 5.0 - APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION
5/3/99
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