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PRELIMINAR OTICE AND. REPORT ~
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: 9~~~..~~ Te Co~u~~ of tIN Stah ef f~d~ as C~iakaK of Rw~N ~
TALLAHASSEIt, I~LORIDA
~ Fa AII R~idaot Bs~ta for tbe Pmrpo~s af D~e~erm~oioa Srbta T+iaic IJabilltp. `
Fa Ait Non-Raddeat Estats~ Ownir~~ Real B~M~s and Tim~,tWe P~eesonal Aroperiy ~n F1o~W~. ~ i
. To be FY~ed bq Dam~? 8seca~on or ~toc: ~md Ve~ilied b~? tbe judae oE tbs Cou~ntp Cowrt a ~
Adawwled~ed BeEoro ~ Notae~? Publia ;
. If the Bs~ee b Retmaabie tio ths Fedaral Covermaaa~ t~OPY OF FSDBML RST[TRN, FORM 70Ay Sho~aW 1
. Be In1ed ~dt6 Thi: Ogioe Oa cr Befoce FYE~eea Mcnd~s AR~ Dats af Deat6. !
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(PL'BA$S RSAD CAREFtJ~~.Y INSTRUCTIONS ON RSVSiZSE SID~ ~
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IN (:OMPLIANC$ WTTH TH8 PROVISIONS OF THE BSTATl~ TAX LAW OF . TAB STATS OF ` ~
FIrORIDA, CHfAPTTsR 198, PZ.ORIDA STATUTI'sS. . "
~ f~Or1~TC8 IS HBRSBY GiVSM- OF ~THS DBATH OF Ma J D~4ra
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' who died on the.....14.L~_d~y - -M8Y'rh _~9.~, sund wl~o wu s r~sideat of +
; l~.artin ~,,,~y, sm~ ~ Florida +
~ ~ Nons ,~p~~t~ No adminiaLratilon had ~
. c~-~?a iw..-w«:i ~ ~ u~~-.~~w ~
~ a~e ~ae~ ~~a a~ea«~t o,~, a~o aay ~ ~ la=--~-, u~? ~ ;
cc~.w'.as... ~ oaR ~.~..._._Couct of.___ Cau,ty, Sta~e ~ t
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' t Tt~e deoede~nt lek an Estate both witl~in and without the State of Florkla oonsi~?g cf •the f~IIovviag meattoned
, , iteaas of . ~ty, the aawunt aet o ta ~ch being the estlmated value theseof (:how g~oss ratLer th~n nat valu?
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j Deduct~onsp~ ~:a~ debb, $eas, etc., a~repotbed only in a oompleM t+eturn in tbe eveat oae is requtrad M be 81ed.
~ ~ $~~~'~e44~~ i~ a~~,.) .
' I.ot 2 Oak La~ns 1Kanor P1aL Book 2 e Martin _ CounL „
~ or da, pub c records;and, tract in Sti Luc e County, orida,~
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. . to ; run 1. 5 t o p; to ~ra ra' e e bf 12 _ Soo. oo***
~ over)
. Tangible peraonal p:apesty in F1orWa (Copy Inventory attacLed) ~....~QA~_._._.:.. .
Real F.state not in FMr~da . ~~.None ~
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' AD Othar Propaty W6ere~rer Sltuates .
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~ stodcs ~tna Bonds _ ~ 1~Ln~ ~
M~ases. Notes and ~'as~+ = None . ; I
All other propetty n~ clas~dRed above ~ below.___ - ~ Non s ~;J
Property wNned io3ntly wfth suiviving spouse_.._plug *~*a va = I
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I.tfe Inrunnoe fos B~neHt of EstAtc ; Non~~ . ~
. . Other L3fe In:ur~nce ~ 33~- ~
Trnsts i~ated by docedent while livla~ = Heny. •
. ~'s~ble Transf~s of Dooede.ut ; Nons ~
I,isc any ;gifb or Tran~ers made by deoedent vvltbm Svs y~+ars_ ~ ; None - .
(sxoW vALVE OF ALL ABOVS ASSB'T5) Denotea lhll ~alus TOrrALr ;_._1~.,~3~_
Did Deoedeut at any tia4e by will or o~?~e ~e
c~se~a ~it~~ bi ap~o,~ntmeat? No
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~ Did Deosdent at aay Hme tran:fer P~'oPe',riY bY e~cerci:e af geaa~i pawer of sppo3nboa~tt
Is TLis F•st~ete wbject ~u ~cdaal S~late Ti~z R~tu~aP
! ALL OF THK ABOVS QUF.STIONS~ MU$? BE ANSVVSItED - . . ~
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~ ~ Su~ ag-'~a ~~~~`~d~~~al6'ttsir
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` . 3t~t~ R.~uts, ,~.4,,. JenseA Bsach.__F~Qr~da
~ ~ t l ~ " ~ _ ^ i+o~ c~....+a«.
, ^ ' STATE OF
: FLORIDA - - -
' SS.
~ ~ . COUNTY OF ~ I+iAR~i ~ . '
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s,~, x: Dse~'..~ a,ma b,? me $nt adP ~l?.a._. d~n ti,., e~,.~.d' tLe ~?s
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;~~i' t~t~ ~~a.~!lgtea~enb t5e~ejn oonb~ined are true bo tbe beet ledge and belkf
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~ ~toa:~ ~ . tLe_.t~'~ a.y eE ~ch_._ ls~.
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~ ~ t St*,.~.~ E' • 1~Y r'~t art 6~ ~a ti dw~io01~e1? w~e~e~r R~. j".. ~ Z~
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