PROBATE COURT OF ________________ COUNTY, OHIO
ESTATE OF __________________________________________________________, DECEASED CASE NO. ________________________
CERTIFICATE OF TRANSFER NO. ________
[Check one of the following] Decedent died intestate. Decedent died testate. Decedent died on ______________________________________________ owning the real property described in this certificate. The persons to whom such real property passed by devise, descent or election are as follows: _________________________________________________________________________________________________ Name Residence Transferee's share Address of decedent's interest _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
[Complete if applicable] The real property described in this certificate is subject to a charge of $________________ in favor of decedent's surviving spouse, ___________________________________________________________ in respect of the unpaid balance of the specific monetary share which is part of the surviving spouse's total intestate share.
12.1 - CERTIFICATE OF TRANSFER
10/1/98
(Reverse of Form 12.1)
The legal description of decedent's interest in the real property subject to this certificate is: [use extra sheets, if necessary].
Prior Instrument Reference: Parcel No:
ISSUANCE
This Certificate of Transfer is issued this _______ day of _______________________________________, 20____.
____________________________________________________ Probate Judge
CERTIFICATION
I certify that this document is a true copy of the original Certificate of Transfer No. _____________ issued on _____________________________ and kept by me as custodian of the official records of this Court.
___________________________________ Date
___________________________________________________ Probate Judge By ________________________________________________