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~ -~ PRUBATE COURT ~F- CUYAHOGA COUNTY, OH10
FR/1NCi5 J. TAITY. P~esidin~ Jud~~
• JOSEPH J. NAHRA. Associat~ Judga
ESTATE OF .
Case No.
Docket
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Page
, DECEASEO
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SURVIVING SPQUSE, NEXT 4F KiN, tEGATEES AND DEVISEES
[Use with thost applications or filings raquiri~y some or all
__ of the i~fomnstion in this form. for notice
or other pu~poses. Updat~ as required]
The foliowing are decedent's k~own wrviving spouse, and other known wrvivors wF~o are or wouid be entitled
to inherit under the statutes of descent and distritwtion.
Name Residence Relationship Birthdate
~ Addre~s to Decedent ~ of Minor
Surviving
No surviving spouse Spouse
JI VV A• f.s./L{{ V4• ~
J: Fred Anderton Fairview Park, Ohio 4412b Son Adult
4921 Ray~ond Drive ~ _
H. Thomas Anderton ~ La Verne, California 91750 Son Adult
.
[Check whichever of the following is appficable]
C7 The wrviving spouse is the natural or adoptive parent of at I~ast one of decedenYs chitdren.
O The surviving spouse is nat the natu~at or adoptive parent of any of decedenYs thildren,
FORM 1 A- SURVIVING SPOUSE. NEXT OF KIN~ LEGATEES AND DEVISEES
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