HomeMy WebLinkAbout2166 P'°'m ar.~.`°'8 pRELIMINARY NOTICE AND REPORT
~01t-Re~.lll•Zt-6~~ To Comptrolle~ of N+e StoN of fiorido 164811 ~
TALLAHASSEE, FLORIDA
For AU ResideAt Estates for the Pur~wse of Determiniag Fstnte Tw~ Liability. ~
For All Non•Residept Estates Ovming Real Fstate u~d Twagible Persooal Property in r..~rida. i
To be Filed by Domiciliary F.~cecutors or Administrators and Verified by the judge of tbe County Court or
Adanowledged Before a Notary Public.
If the Fstate Is RPhunable to the Federsl Covernment, COPY OF FEDERAL RET~JRN, F'ORM 708y Should
Be Filed with This Olfioe ~ or Before Fifteen Moaths After Date of Death. ~
~1'l.l:~til: Ith::~O (:.1itEl't~l.l.1~ 1\ti1'ltl'(:"1'1O\ti l)\ lit:~'H:tt~I•' SlnE:i ~
IN COMPLIANCE WITH THE PROVISIONS OF THE ESTATE TAX LAW OF THE STATE OF ,
FLORIDA. CHAPTER 198, FLORIDA STATUTES.
NOTICE IS HEREBY GIVEN OF THE DEATH OF____~ v!~~~?~'~'_`_~1 ~
who died on the _~~--_---day of------- --------------19-- and who was a resident of
l/ ~ .
- , State of__~r~_
- - ----APPointed___~-~.-_~~~@~.--- ~ - - ~
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R-w.) cw..-w.~) cs~~-e co~ ;
of the Fst of said decedent on the__._. 3 ~~._.day o____ - ---.~_____________.___,~19rO~_, by the
~ ~
- - --------------Court of----- --------County, State of-------------------- '
- -
cCounb Iwl~e's or otber Co..rt) '
a
The decedent teft an Estate both within and without the State of Florida consisting of the following mentioned
items of property, the amount set opposite each being the estimated value thereof (show gross rather than net value.
DeducNons for debts, liens, etc., will be reported only in a oomplete return in the event one is required to be 61ed.)
Real Estat . in Florida ( Give legal escription. ) _ ~
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angible personal proper~y" in Florida (Copy Inventory attached)--------___--------------------------.
Real Estate not in F'lorida---------------------------------------------------------------------_-_-----------------------------------
FILED ~.PJ~ RECORDED
All Other Property Wherever Situate: ST. C' ~ ~ C U~ ~TY, F ~A.
- -
Stoclcs and Bonds----------------------------------- - - - ------------------------------------------=i~~8~~ -
;
Mortgages, Notes and Cash - - - - ~
' All other property not classiSed above or below 3~~~ z~ P~ L.~~ ~ ~~i ~
Property owned joindy
, . . , - - ;
(gi~•e legal descnphon) - _ _
- - - - - _ _ _ -
C! -?~K ~lR~iJi~ CbURT
I Life Insurance for Benefit of Estate _ _ - _ - -
I
Other Life Insurance-------------------------------------------------------------------------------------------------------------------------- Z----------
Trusts created by decedent while living s-'-}zQ~?"-~~------
Taxable Transfers of Decedent-- Z--~?'`=°~-"`:=`-
List any gifts or Transfers macle by decedent within three vears $-.^~u-'„`--~--- -
- -
(SHOW VALUE OF ALL ABOVE ASSETS) T~T~. p~
Did Decedent at any time by will or otherwise exercise a limited power of appoinhnent?_______l~"''v_.___
Did Decedeat at any time transfer property by exercise of general power of appoinhnent?_.._._
~'`'L'
I. l hir i.,t:tic ~uhiri t tn Fedcr:ii F.t.~tr l~:i~ Rch~rti:'
ALL OF THE ABOVE QUESTIONS MUST BE ANSWERED
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~ Admioi~trt AdmEni~nt+i:
~ Eaea~t~-E:e~vtr~
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~ Pwt Osa~e Add~ear
~ sT~TE oF--------- MISSOURI--------------------- - - ~`~'~o
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~ COU OF.-~-=-------Cole--------------
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~ AtA~ ~~2~._~VO~!A~
CIC---------------------BeinB by me first duly sworn sa}~------ tha~-----~he-----------~ -----sead the foregoing
~
.
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~ treport and 't~%~e statementr therein contained are true to the best of__________._______heY_'_______Irnowledge and belief.
~ ~ ~ ~ ' ~ ~ 16th October 67_._
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` ~~Ddted at~J:~f~'fl]Cfl4X1__~i~Y~---~Q-•------, the --------------day of-----~ 19--
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~ ~ ~ ~ ~$,~I.,f = - c'~ ;~-1x_%~y_"~_c~.~-~---~ --1- - - - - M
~~rJ. i~r o e County, o.
:~!ix•.x.er~~ ex}~ires: Nov. 7, 1967.
i • . " l fii. re~~i,~rt n~u.t Lc ~ ~ct ~~f,~d ~1~~:0.:~ ~I~ ~r. ~ ~ci u!~~r. .u}iuii•i.!r.~fi~r ~ . :i~ ini[ ~p~•u.,
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