PROBATE COURT OF ________________ COUNTY, OHIO
ESTATE OF ____________________________________________________________, DECEASED CASE NO. _______________________
WAIVER AND CONSENT WRONGFUL DEATH AND SURVIVAL CLAIMS
The undersigned waive notice of the hearing and consent to and approve the settlement and distribution as set forth in Form 14.0, Application to Approve Settlement and Distribution of Wrongful Death and Survival Claims, a copy of which I have received.
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FORM 14.1 - WAIVER AND CONSENT WRONGFUL DEATH AND SURVIVAL CLAIMS
4/1/97