PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE

ESTATE OF LEONA
___________________________________________________________,
DECEASED
BAYN FARRELL
CASE NO. ________________________
2012EST9999

NEW CASE INFORMATION STATEMENT

THE UNDERSIGNED CERTIFIES THAT THE WILLS ON DEPOSIT HAVE BEEN EXAMINED AND NO
LATER WILL WAS FOUND ON DEPOSIT FOR THIS DECEDENT.

WILL DEPOSITED IN THIS COURT ON __________________________ IS HEREBY WITHDRAWN AND

ATTACHED HERETO.

________________________________
DEPUTY CLERK, PROBATE COURT

ATTORNEY OF RECORD TO COMPLETE THE FOLLOWING SECTION

THE UNDERSIGNED CERTIFIES THAT THIS CASE IS, IS NOT RELATED TO ANY CASE NOW
PENDING IN ANY JUDICIAL SYSTEM.
CASE NUMBER OF RELATED CASE __________________________
DESCRIPTION AND JURISDICTION OF RELATED CASE _______________________________________
PLEASE CHECK ONE OF THE FOLLOWING:

ESTATE OR RELIEF FILED HEREWITH

WILL ONLY

TAX ONLY

REAL ESTATE ONLY

ESTATE OR RELIEF EXPECTED TO BE FILED ON OR BEFORE ___________________________________

OTHER _____________________________________________________________________________________
PLEASE CHECK ONE OF THE FOLLOWING REGARDING CITATION TO THE SURVIVING SPOUSE:

DATE OF DEATH IS ON OR AFTER JANUARY 1, 2002, CITATION TO SURVIVING SPOUSE TO ISSUE

FOR DATES OF DEATH PRIOR TO JANUARY 1, 2002

SPOUSE IS SOLE BENEFICIARY, CITATION IS UNNECESSARY

SPOUSE IS NOT SOLE BENEFICIARY, PLEASE ISSUE A CITATION
NO SURVIVING SPOUSE
NO WILL FILED FOR PROBATE
CITATION TO SPOUSE IS TO BE ISSUED AT REQUEST OF ATTORNEY OF RECORD

STATEMENT OF PERMANENT ADDRESS

The following address is my permanent address. I understand that I am required to notify the Court of
any change in my address and that the Court is authorized to remove me if I fail to comply with this
requirement.
Signature, Applicant

Signature, Attorney of Record

GARY E. HORN

Print Attorney Name

1796 INDIAN WOOD CIRCLE

Address

MAUMEE, OH 43537

(419) 555-1212

Phone Number

OREN JOHNSTON FARRELL

913 GARTH STREET
Address
TOLEDO, OH 43613

Print Name

Phone Number

0016297

Ohio Supreme Court ID Number

FORM 1-A - NEW CASE INFORMATION STATEMENT

REV. 01/2012

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE
ESTATE OF ______________________________________________________,
DECEASED
LEONA BAYN FARRELL
2012EST9999
CASE NO. ______________________

APPLICATION TO PROBATE WILL

[R.C. 2107.11, 2107.18, and 2107.19]

APRIL 20, 2012

Applicant states that decedent died on _____________________________________________________
913 GARTH STREET
Decedent's domicile was __________________________________________________________
Street Address

LUCAS
TOLEDO
______________________________________________________________________________
City or Village, or Township if unincorporated area

County

______________________________________________________________________________
OH
43613
Post Office

State

Zip Code

A document purporting to be decedent's last will is attached and offered for probate, and applicant waives
notice of probate of this will.
Decedent's surviving spouse, children, next of kin, and legatees and devisees, known to applicant, are
listed on the attached Form 1.0.
_______________________________________
Attorney for Applicant
_______________________________________
GARY E. HORN
Typed or Printed Name
_______________________________________
1796 INDIAN WOOD CIRCLE
Address
MAUMEE,
OH 43537
_______________________________________

_______________________________________
Applicant
_______________________________________
OREN JOHNSTON FARRELL
Typed or Printed Name
_______________________________________
913 GARTH STREET
Address
_______________________________________
TOLEDO,
OH 43613

(419) 555-1212
_______________________________________
Phone Number (include area code)

_______________________________________
Phone Number (include area code)

0016297
Attorney Registration No. _________________

WAIVER OF NOTICE OF PROBATE OF WILL

The undersigned, being persons entitled to notice of the probate of this will, waive such notice. After a
certificate is filed evidencing these waivers and any notices given, any action to contest the validity of this
will must be filed no more than three months after the filing of the certificate for estates of decedents who
die on or after January 1, 2002 and no more than four months after the filing of the certificate for estates
of decedents who die before January 1, 2002.
_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

FT3/16

PAGE 1 OF FORM 2.0 APPLICATION TO PROBATE WILL

12/01/02

CASE NO. _____________________

2012EST9999
ENTRY ADMITTING WILL TO PROBATE
The Court finds that the purported will of decedent, either on its face or from testimony of the witnesses,
complies with the applicable law. It is therefore admitted to probate, and ordered recorded. The Court
further orders that notice of the probate be given to all parties entitled to notice.
_________________________
Date

_______________________________________
Judge Jack R. Puffenberger

CERTIFICATE OF WAIVER OF NOTICE

The undersigned states that all persons entitled to notice:

[Check applicable boxes]

Have waived notice of the application for probate of this will or of a contest as to jurisdiction.
Have waived notice of this wills admission to probate. The waivers are filed herein.
Have not been notified because their names or places of residence are unknown and cannot with
reasonable diligence be ascertained.

___________________________________________

Fiduciary
Applicant for the admission of this will to probate
Applicant for a release from administration
Other interested person
Attorney for any of the above

Attorney Registration No. 0016297

______________________

PAGE 2 OF FORM 2.0 APPLICATION TO PROBATE WILL

12/01/02

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE
LEONA BAYN FARRELL
ESTATE OF ____________________________________________________________,
DECEASED
CASE NO. _________________________
2012EST9999

SURVIVING SPOUSE, CHILDREN, NEXT OF KIN,

LEGATEES AND DEVISEES
[R.C. 2105.06, 2106.13 AND 2107.19]
[Use with those applications or filings requiring some or all of the
information in this form, for notice or other purposes. Update as required.]

The following are decedents known surviving spouse, children, and the lineal descendants of deceased children.
If none, the following are decedents next of kin who are or would be entitled to inherit under the statutes of
descent and distribution.
_____________________________________________________________________________________ ______
Name
Residence
Relationship
Birthdate
Address
to Decedent
of Minor
913 GARTH STREET TOLEDO, OH 43616

OREN JOHNSTON FARRELL

Surviving
Spouse

4972 HILLSIDE DRIVE TOLEDO, OH 43612

RANDOLPH BAYN FARRELL

SON
____________________________________________________________________________________
913 GARTH STREET TOLEDO, OH 43616

THOMAS EARL FARRELL

SON
3/4/1996
____________________________________________________________________________________
ELLA GAMBLE DEAN
NIECE
____________________________________________________________________________________

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
[Check whichever of the following is applicable]
The surviving spouse is the natural or adoptive parent of all of the decedents children.

The surviving spouse is the natural or adoptive parent of at least one, but not all of the decedents children.
The surviving spouse is not the natural or adoptive parent of any of the decedents children.
There are minor children of the decedent who are not the children of the surviving spouse.
There are minor children of the decedent and no surviving spouse.

FT2/13
PAGE 1 OF FORM 1.0 SURVIVING SPOUSE, CHILDREN, NEXT OF KIN, LEGATEES AND DEVISEES

12/01/02

CASE NO. ____________________________

2012EST9999
The following are the vested beneficiaries named in the decedents will:
_____________________________________________________________________________________ ______
Name
Residence
Birthdate
Address
of Minor

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
[Check whichever of the following is applicable]

The will contains a charitable trust or a bequest or devise to a charitable trust, subject to R.C. 109.23 to 09.41.
The will is not subject to R.C. 109.23 to 109.41 relating to charitable trusts.

____________________________
Date

_____________________________________________
Applicant (or give other title)
_____________________________________________

PAGE 2 OF FORM 1.0 SURVIVING SPOUSE, CHILDREN, NEXT OF KIN, LEGATEES AND DEVISEES

12/01/02

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE

LEONA BAYN FARRELL

ESTATE OF ______________________________________________________,
DECEASED
2012EST9999
CASE NO. ________________________

ENTRY ADMITTING WILL TO PROBATE

The Court finds that the purported will of decedent, either on its face or from testimony of the
witnesses, complies with the applicable law. It is therefore admitted to probate, and ordered
recorded. The Court further orders that notice of the probate be given to all parties entitled to
notice.

_________________________
Date

____________________________________
Judge Jack R. Puffenberger

FT3/4E
EST 2.3 ENTRY ADMITTING WILL TO PROBATE

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE
ESTATE OF _____________________________________________________________,
DECEASED
LEONA BAYN FARRELL
CASE NO. ______________________
2012EST9999

APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION

[R.C. 2113.03]

Applicant states that decedent died on ______________________________________________________________

APRIL 20, 2012
Decedents domicile was ________________________________________________________________________
913 GARTH STREET
Street Address

_____________________________________________________________________________________________
TOLEDO
LUCAS
City or Village, or Township if unincorporated area
County
43613
______________________________________________________________________________________________________
OH
Zip Code
Post Office
State

[Check one of the following]

Decedents will has been admitted to probate in this Court.

To applicants 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 $ 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.

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; and the surviving spouse is entitled to all of the assets and the decedent died on
or after April 16, 1993.

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 decedents surviving spouse, next of kin, legatees, and devisees known to applicant, are listed on the attached
Form 1.0.
__________________________________________
__________________________________________
Attorney for Applicant
Applicant
__________________________________________
__________________________________________
GARY E. HORN
OREN JOHNSTON FARRELL
Typed or Printed Name
Typed or Printed Name
913 GARTH STREET
__________________________________________
__________________________________________
1796 INDIAN WOOD CIRCLE
Address
Address
__________________________________________
__________________________________________
TOLEDO, OH 43613
MAUMEE, OH 43537
__________________________________________
(419) 555-1212
Phone Number (include area code)

__________________________________________
Phone Number (include area code)

Attorney Registration No. ____________________

0016297

Ftu6/1y
PAGE 1 OF FORM 5.0 APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION

3/99

WAIVER OF NOTICE

2012EST9999
CASE NO. _________________

The undersigned surviving spouse, heirs at law, legatees, devisees, and other persons entitled to notice of
the filing of the application to relieve decedents estate from administration, waive such notice.
_____________________________________

_______________________________________

_____________________________________

_______________________________________

_____________________________________

_______________________________________

_____________________________________

_______________________________________

ENTRY SETTING HEARING AND ORDERING NOTICE

ftiI
9
MAY 15, 2012
The Court sets _____________________________________,
at _________
0clock ____.
A M., as the date
and time for hearing the application to relieve decedents 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

___________________________________________
Judge Jack R. Puffenberger

PAGE 2 OF FORM 5.0 APPLICATION TO RELIEVE ESTATE FROM ADMINISTRATION

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE
LEONA BAYN FARRELL
ESTATE OF _____________________________________________________________,
DECEASED
CASE NO. ______________________
2012EST9999
ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION
Following is a summary statement of the character and value of the assets in decedents estate [Insert a check
in the Appraised column opposite an item if it was valued by the appraiser. Leave blank if the readily
ascertainable value of the item was determined by applicant. Use extra sheets if necessary.]
Automobiles distributed to surviving spouse by affidavit

Value

First automobile selected by surviving spouse under R.C. 2106.18

[Omit value when computing total assets] ------------ Appraised Value $
Second automobile selected by surviving spouse under R.C. 2106.18
[Omit value when computing total assets] ------------ Appraised Value $
Total Value [not to exceed $40,000.00]
Character of asset

Real Estate, described in accompanying

Certificate of Transfer No. 1

Other assets
SAVINGS ACCOUNT

XXXX

15000.00

XXXX
XXXX

15000.00
Value

Appraised

100000.00

15000.00
30000.00

CERTIFICATE OF DEPOSIT
JEWELRY

400.00

CLOTHING

200.00

Total Assets

$
145600

ftu6/28
PAGE 1 OF FORM 5.1 ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION

REV 4/1/97

Following is a list of decedents known debts. [Use extra sheets if necessary]

2012EST9999
CASE NO. ______________________
Name of Creditor

Nature of Debt

Amount

$
ELDER-BEERMAN

STORE CREDIT CARD

KEN'S FLOWER SHOP

BALANCE DUE ON ACCOUNT

5000.00
175.00

Total Debts

5175

CERTIFICATION
The undersigned appraiser agreed to act as appraiser of decedents estate, and to appraise the property
exhibited truly, honestly, impartially, and to the best of the appraisers knowledge and ability. The appraiser further
says that those assets whose values were not readily ascertainable are indicated above by a check in the
Appraised column opposite each such item, and that such values are correct.
The undersigned applicant determined the value of those assets whose values were readily ascertainable
and were not appraised by the appraiser, and that such values are correct, and to applicants knowledge the above
list of decedents debts is correct.
_______________________________________
Date
_______________________________________
Appraiser

________________________________________
Applicant

PAGE 2 OF FORM 5.1 ASSETS AND LIABILITIES OF ESTATE TO BE RELIEVED FROM ADMINISTRATION

REV 4/1/97

PROBATE COURT OF LUCAS COUNTY, OHIO

JACK R. PUFFENBERGER, JUDGE
LEONA BAYN FARRELL
ESTATE OF _____________________________________________________________,
DECEASED
2012EST9999
CASE NO. ______________________

ENTRY RELIEVING ESTATE FROM ADMINISTRATION

Revised Code Sec. 2113.03

Upon hearing the application to relieve decedents estate from administration, the Court finds that:
Decedent died [check one of the following] [] testate [ ] intestate. The date of death and
domicile are as stated in the application, and the Court has jurisdiction over the estate;
Notice to the surviving spouse, heirs at law, legatees, devisees, and other interested persons was
duly effected or dispensed with by the Court as unnecessary;
The values of the several assets in the estate, given in the application do not exceed the statutory
limits.
The Court therefore relieves the estate from administration, and orders [check and complete
whichever of the following are applicable]:
[ ]

That the following personal property be sold [describe]:

[ ]

That the following debts of decedent shall be paid to the extent of the assets:
$5,000.00 TO EDLER-BEERMAN
$175.00 TO KEN'S FLOWER SHOP

[]
That the statutory family allowance be paid to the [] surviving spouse [ ] minor
children of the decedent [ ] apportioned between the surviving spouse and the minor children of the
decedent who are not the children of the surviving spouse. Attach Form 7.2A if necessary.
[ ]
That Certificate of Transfer No. _____,
attached to the application and describing
1
decedents real estate, issue and be preserved in the records of the Court and that authenticated copies of
the certificate be delivered as required to the persons entitled to them;
[]
That the financial institutions holding accounts in decedents name as set forth below pay
the same upon proper tax release [check one of the following] [] to the commissioner [ ] to

[]

That the remainder of the estate be distributed in cash or in kind, as follows:

FT6/7]
PAGE 1 OF FORM 5.6 ENTRY RELIEVING ESTATE FROM ADMINISTRATION

2012EST9999
CASE NO. ______________________

Name of Distributee

Property

Value or
Amount

OREN JOHNSTON FARRELL

SAVINGS ACCOUNT

OREN JOHNSTON FARRELL

CERTIFICATE OF DEPOSIT

OREN JOHNSTON FARRELL

JEWELRY

400.00

OREN JOHNSTON FARRELL

CLOTHING

200.00

TOTAL $

15000.00
30000.00

45600

The Court appoints ________________________________________________________________,

Commissioner to receive and sell or distribute the personal property or proceeds thereof, and to execute
all necessary documents of conveyance, including without limitation those necessary to transfer title to
any motor vehicle, motorcycle, watercraft, or other titled personal property sold or distributed in kind.
The commissioner shall complete his duties and report to the Court within sixty days of the date of this
entry.

___________________________
Date

___________________________________________
Judge Jack R. Puffenberger
Print Packet

I, GARY
_______________________,
E. HORN Attorney-at-law,
hereby certify, that the within instrument was
prepared and/or examined by me, and that the
same, in my opinion, is correct and proper.

Reset Packet

PAGE 2 OF FORM 5.6 ENTRY RELIEVING ESTATE FROM ADMINISTRATION