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Estate of:

                                   Schedule D – Insurance
          (Jointly owned property must be listed on Schedule E)

Insurance on the life of the decedent payable to a benefi ciary contracts, such as a matured endowment or supplemental 
other than the estate, is not includible for Ohio estate tax   contract wherein the insurance or risk feature ceased prior 
purposes. Insurance payable to the estate and insurance        to death, are includible for Ohio estate tax purposes.

Item                                                           Value at Date
Number                             Description                 of Death
1.

Total from continuation schedule(s)

Total (also enter on Recapitulation of Assets, page 2)

                                   Schedule D