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M'- PRELIMlNARY NOTICE AND REPORT
T. ~1~.M« .f MN i~.t~ .t f1..i~s
TALL~HAtiE~, KA~IO~A ~~it~~„ ~ ?
Fo~ M R~oR ~ for t1M A~rpo~ d D~~i~i¦~t bta/~ Tis Li~bOitr. i
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Far A~ No~-A~aideot Babbs O~ lteal ~ add Tae~bi~ Iwsoo~l l~opeetr ta Fforida.
To be F~iMkd bp Do~eidWe~ 8~scnloa ae Ad~ralon a~d V~t~ed bp dr jwlp af tw G1ou~er (Jo~et or ~
AdrnowMdsed Hefoe~e • Not~ry Iubiia .
If die Esta~e L Ratnrnable b tbs F~d Cov~ern~eoR, QOPT OF FBDBBAL ~RN,1++OR11t TOA~ ShoWd '
Be Flled ~Ith 71ib QBo~ Oo ~ Deloa FiEbeea Ido~tLs APoar Dr/e af Dealh. ~
(PI.F:ASE KEAD CAREFULI.Y INSTRUCTIONS ON REVERSE SIDE)
IN apMpLUNCE WiTH . TH8 PROVISIONS OF TRB SSTATS TAX LAW OF THS STATS OF
FIARIDA. CHAPTER 198, FLORIDA STATUTES.
NOTICS IS HSREBY CIVSN OF TH8 DE/1TI~I OF ~RTHUR L~ LON_ER~_____.~M__
w1w dled an ths..i~_~..__._day of._~__....NS?Y~,~r 1~.4_.~, aad wbo was a resident oE
I ndtan R
i_ vg.r _..____C,a,uty, 5tate of rSLd~ -
~I an~ the sole surv[ving spoue~ ~t~~~ -
-----------a= a I~po -
w cw..-w«.~ ~.-~bw
of the Estate of said deoedent oa the_~~----_-----daY ~ -----------,19___.._, by the
------_-----------------------_.Court o#.---.----------- .____Couaty. State of------------_________________-----------------
(Co..~er )~a'• or oeMr Cor.y
~I~IC dCO~Cat ICf~ ~ C'
S~~C b0~ N?~~Iq ill~ Wlt}WUt d1E $bM Of MO[~ OOOSISNR$ OE ~E fOIION/~g I[IEAHOIIEd ~
lieiflS Of p['O~~
s~@ iiliWllUt SCt ~8 PAC~I bC1Ag ~10 dS~il~~ V~liO ~IE[E0~ ti~l0'W ~'OiRf Iu~ ~Wt IICt V~UE. I
DC(~IIC'IIOOS IO~ a6~, }~C[lis 6tC.~ 11Y~~~ Oil~y ID i CO~1~Eb0 ~Itnl 1D d!C @V80~ OOE ~t I'E~L~[Ed ~~1E ~Cd.~ :
Real F.state in ~Iorida ( Give legal description. )
- - _ -L~.~--------
Tangible personal property in Fiorids (CoPY Inve~ntory stttached)
Real F.itate not in Florida_-------.__-------------------------------------- i------none-------------------
All Ot~er Pro~rtp iNbereva Situa~
stock: and Bonds----------------------------- - _-------none-------
Mortgages. Notes and Cash-----------------
' All other property not dassified above or below i-------~_II_4I1~-------
j Property owned joindy
; (gi~e legal descc;riphon)~e Schedule__•~A',_attached here_to . =_12a_00~, (?0
i Life Iaturance for Bene6t of Fstate- - none
- - -
, ~
! Ocher I.ife Insurance------_____-_-------------------------------------~____---------_____ _------none__------------- ~
~ Tnuts created by decedent while livin8----------------------------------
~ ;----"°"-e------------------ '
1
~ Tausble Transfe.rs of Deoede~nt------=-----------=---------------------------------------------------- none ;
List any gifts ~ Transfers made by decedent within chree years _ i.-------none----_._------ -
TO'r~., i.12,-~~20•-~4-------- - ~
(SHOW VALUE OF ALL ABOVE ASSETS)
€
Did Decedent at any time by will or otherwise ea~ercise a limited powe,r of appointmeat~__.------------r0----------------------
~ Did Deoedent at any time transfer P~P~Y b'Y eierciae of general povrer of appointment?-------------~~------- r
~ Is This Estate subject to Federal Estate Tax Return? NO
ALL OF 'I~IE ABOVE QUESTIONS MUSi BE ANSWERED
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~ L_..'c,~`"t... ~-i ~ _L`?.~-L~_-
~ -f---------- - uriiving' E
~ "pouse '
= 623_Nassau_Lane, Vero_BeachR._Florida _ . .
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~+.R o~o. waa~.
~ S'I'A1'E OF_-------~~Q.LI~-- -
~
~
~ ~u1~'~X:;OF_.3ndlBn_.$ix~es___---------------------------------------
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,~~~,j.~I---------------._..Being by me first duly sworn sa~___ that~be---------__~.___sead tbe focegoing
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tLe statemeats therein contained are hve eo the best of~-------------L~L-----Jwowledge aad belief.
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~ ' t~~,~ ' ~ ach~F L4.~'..~---------, tbe ._.7~_._._...~r cf_____ - 1971
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