HomeMy WebLinkAbout2058 FormE.T.(:-6U18 pRELIMINARY NOTICE AND REPORT
Rev. (3-1-69,
. To Coenptrolle? of the State of Florida
TALLAHASSEE, FLORIDA
I~ CUr1PI.IA\CE ~1'17'lI 1'HE 1'1tU~'1~IU\~ UF '1'HE 1~.~'1'.~'I'I•: 't'.\~ 1.:1\1' l?1~' '1'I!E ~'1':\'t'N: l>1•' F1.~?ltll~:1,
CHAPT1:It ]98, FLORInA ST:1Tt'TES, \OTICE IS IIEIt1~.131' (~I~'F.\ l~F T11E 1)~:aTl[ (~F
Decrdrnt's first ~~xmr and n~iddlr iniii~i I~1Y'IYII•I1~'. I:rt n:~m~• I~:~t~• ~+f de~at6
ZACKERY M. CRUMPLER Januar~ Z8, 19T1
Resideuce (domieik) at time o( destti Ucry~f~•nt ~~v~ned n•al pn>perty in
S 106 Airenue Q, Ft. Pieree, 1~'lorida St. Lncie,
cc~an~y, Fk,rulx
tiamr, Title, and sddrrs~e of execulor. xdmiaisirntur, or pr~nn in ~x~seea,N~n ut d~r•~.1~•nt's pn~pNrt~•
ALICE M. BURNEY, 190Z N. W. 47t~ Terrace, ~iami, Flo~rids
I~ame and eddresa of attorney for eaLate ;
GEOR~E S. OKELL, SR., 158~ N.W. ~6th Street, ~[iami. Florida S~is!
It estate ia being admu~istered give title snd location of cc,urt end dxtr ut appointmrnt as rrpn~ntati~•e
No administration oi estate
The decedent left an Estate both aithin and aithout the State of Florida consisting of the folloAing mentiuned item~
of property, the amount set opposite each being the estimated value thereof (show gross rather than net value.
Deductions for debts, liens, etc.~ ~ill be reported oniy in a complete return in the event oue is required to t~e tiled.)
Reul Estate in Florida (Give legal description of all real property in nhich decedent u«•necl an interest_)
--------------L.ot._.ls__.na__1T_ Bloclt 8... H!!R3[orn~..HEICHTS,~--a._recolaea :
in P1at.Book.B,~---Pa~e--z4--in-the--Pnbtic_Recozd~_ oi St....Lncie _ ~
---Cownty_.---Florida----- ---Total.value of_Pi'opert7. ir_ i5, 000..-----,--. - '
----Decedent!~_intereet_ is..~z..500,-00-------------------------- - - '
_ ;
- - g Z. 500.._00. ,
, (Coatinue on separate schedule if necessary) ~
~
Tangible personal property in Florida (Copy Inventory attached) . . . . . . . . . . . ~e ~ _
Real Estate not in Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOI~IE
All Other Property Wherever Situate:
I -
NONE
~ Stcek ~nd bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -
Mortgagee, notes, and cash . . . . . . . . . . . . . . . . . . . . . . . . . . . • ------NQ~
~
Insurance on decedent's life . . : . . . . . . . . . . . . . . . . . . . . . . . . . -NQI~S. .
NO1~E
~ Annuities . . . . . . . . . _ . . . . _ ~ . . . . . . . . . . . . . . . . . . -
Jointly owned property (other than real estate) . . . . . . . . . . . . . . . . . . . . .~0~
Transfers during decedent's life . . . . . . . . . . . . . . . . . . . . . . . . • - I~IOIrIE._----..
Powers of appointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . • - NQNE
All other pmpert y . . . . . . . . . . . . . . • . . . . . . . . . . - - - - . N~NE _
'rOTAL . . ~
Is Thls Estate subject to Federal Estate Taa Return?----- ..--1~IQ----------------.-.------------ =
~ ALICE M. BURNEY_._...__ t?ereLy ac{:nu»ledge under oath that I havc
I------------------
(Name)
~ read the foregoing report and that the statements therein containeci are true and that the same correctly discloses
~ ail of the assets of the decedent named therein nhere~~er locatecl to the be~t of my knowlecioe and belief.
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Au t Za 19TZ r -
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(Dste) (Signature) C1~it e~,,,:~~,~;i.., : .
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St.ate of Flor'ida ~,S~:~sa:`'" ;
, Dade . .
County of . - ~ ; -p.
O~ : J.. . ~,s,~`
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Saorn to and subscr~bed before me this the _.__Z~nd ~f Aa~ut_. ~g7s______,`M;'th~St~te~ac~':~,;: '
County aforesaid. ~ . ~ , : ~ J . ~ '
. ~....__.-._.~.1G+~::e. ' ?
M~ Commiseicn Ezpires •K~~ PUBLIC, STATE OF FLORIDA ~,t Sta t q;~~=
M
Y C O M M I S S I O Y E X P I R E S A P R^ 5. 1~ ~
80HDE0 TH~(11!:;N FREO Fl. DI~STELHOHST'~, ~ ~ ~ ' • „ • ;
~ •
WARNING! Failure to cumplete all Llnnk spaccs ir~ the alr~~•e furm will result in d~la~•in~ thr i;~usm~~• ~~f the pr~~per ~~e~~leS~~trfsp~~
plicable or none show "~O\E". , -
c OOr ~G~ i +~~CE
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