HomeMy WebLinkAbout2099 5 3 9 7. 1`74625 oFF.
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pRELIMINARY NOTICE AND ~ REPORT
Te Cow~phoNe~ of tIN ShN of Fkeid~
TALLAHASSER, FLA~IDA ~
Fa~ All Raideat Ssat,es for tbs A~r~o~e of De~enni~ S~bte T~ I3sbilitp.
Fo: All Non-Rasideat Eshtes Ownina Real Eri~te and Taop'bls Persoo~l Ptope~ty ~ F7oclds. ~
To be Filed by Domidli~? ~ecueocs cr ~toc~ aod VeriBed b~? d~s jwlse oE tbe Co~mty C~ourt a~ ;
Admowledsad Before a Notar~? PuWic. '
If tbe Fst~te Is Ret~nable ~o t6e Fal~ral Gov~rm~eaot, OOP'Y OF FSDBAAI. RRIZJRN, FORM 70Ay Shou{d
Be ~kd w~h '17~is 01~ios On oe B~Eoe~e F'if~eea Maot6s A~ Da~e cf Death. ~ .
(PI.C~SE READ CAREFULLY 1NSTRUCTIONS ON REVERSE SIDE;
IN GOMPLUNC$ WIT~~ THB PROVISIONS OF THS ffiTATS TAX LAW._ OF THE STATS OF
FI~ORIDA, CHAPTER 198, FIAAIDA STA1`UTES. . ~
NOrI'ICE IS HSREBY GIVSN OF TH$ DEATH' OF At~r J. asook~
who died on the.___~ day 8 t~[nD~r 1~_, and who wa= s resjdeat of ~
t
Hro.ua county, state o~~~=taa
-
~'lcla~c• ~t. Ssook+~ ~N~ am tL• •nsviwia,~ rridow aad~otot t~naat__ .
~q~' ._.~~::-w«.i ~ ~-~a.+.rdw.~a~w M
ef-lhe-I~tab-oE-said-i~oei~t-0a•the.s~,~~.aay~.~- -----....~..------------•~•••lA•-••.bye~e
•~•----•••---•••--•--•----_-_-6e~et~_-_------•••••---Ceuohr?~ta~e~f-••---•----•-•••.-
- - •
cCo..ty I.ds~
s ar o1l~r Coat)
T'he decedent left an Estate both within and without the State of P1orlda oonsit~g of tha folbwtng meationed
items of property, the amount set o~ppo~te each being the estimated value thereof (show goss rather than net value. ;
Deductions for debts, liens, etc., will be reported only in a oomplete retunu in tbe eveat one is required tu be filed.) ~
Real Estate in Florida ( Give legal description. ) ;
Lot 1S. blk 22 tu~it 3 L~k~wood Pask, St. L~tc1• Conety. !'L. y s~. P. 8.10
P ~ oi tb~ pnb. r~e. oi Bt. Luci• Coust~ . FZorida AND ZTnit "C"
ot . -27a~~: lainm
a .Bk~26~~ -to~ot~,-~l~.i s~• ~lo~r
Taagi6le pe~soaal property in Florida (Copy Inventory attached
~~i~~. 2'~w00
Real Fstate not in Florida~.~__~___~___ ~
i____------ ~ -----~r-- ~
cn ;
AU Other property Wha+ever Situate: ~
~
Stocks and Bonds-------------------------
_-------------'0-------=~-- :
I, Mort8a8es. Notes and Cash--------------------------------------- 80. 00
~ AU other property not elassiSed above or below ~------------------------------v--
Property owned jointly abow; _ . . • ' . ' . 11, 500. 00 ~ ~
've 1 al deseri tion -----------r~-~----- ~
(8i e8 P - -
Life Iasurance for Benefit of Estate-------------. -0•
~
c,a
. ~
Other I.ife Insurance----- • . , . . ~ - - ~
~--r- . - ~
~.~ll ~ ' 1 f- ~
Trusts created by decedent while livin8_--------------------------------------------------^-_- ;
Tauable Transfers of Decedent----------------------------------------------.•-_______ i^~--- -0-____------ - ~
List any gifts or Transfers made by decedent within three years----------------------------- ;--------------•,Q~--•_-------- ;
(SHOW VALUE OF ALL ABOVE ASSE'I'S) q~~,, =~13, 1 SS. 00
~
Did Decedent at any time by will or otherwise exercise a limited power of appoinhnent?------------~---------------- ;
Did Deoedent at any titne transfer pmperty by e:ercise of general power of appoinhnent?__,__-----~-- ~
#
Is This Fstate subject to Federal Estate Tax Return? _ ~
ALL OF THE ABOVE QUESTIONS MUST BE ANSWSRLD
~~_--`~~---~~~~-_-----------j--- ----_---,~J '
RECORDED iN OFi1C1Al REGGRJ$ BQQK ~~D~~~ Bs 'OiDt t~LaQt if~
Of BR0IMMD COLhTY. FLORIDa u
JACK WHEELER widow ~
CLERK QF CIRCUIT COURT 1723_ZT. W. 6Q~Av ~~Lt?ud. Fla. '
!'losala
S'I'ATE OF_-------------------------------------------.-------•------------
B:owasd
COUNTY OF__.___
Flo~~~~„~t~~s'oo~t! _~:__.Being by me Srst duly swarn say! _ tha~_! he__ ba_~~read the foregoing
~ep~SC~~d tt~t~~M.ststbanent: therein oontained are true ~o tbe best of_____ __h.~= _knowledge and belief.
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