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~ Form pR-301
Rev. 9•O 1-69 ~
. PRELlMINARY NOTICE AND REPORT
TO: ESTATE TAX BUREAU, DEPARTMENT OF REVENUE, l'ALLAHA55E@, FLORIOA, 32304
iN COMPLIANCE WITN THE PROViS10N5 OF THE E57ATE TAX LAW~OF THE STATE OF FLORIOA,
CHAPTER 198, FLORIDA STATUTES, NOTICE IS HEREBY GIVEN OF THE ~EATH OF
OeceoenYS fnst name anO m~Aq~e 1m~~a1 p~cW~nt•s ~au nsma pata of dtit~ .
FRANK LoFORNO April 24, 1971
Res~Aente (tlom~cile) at t~me of death ~acn p laaq r~plopaty fn •
6g43 So. Art sian Street 1 1 (1
Chicac;o, Coo~C_County~ Il~ino~s _ St Lu iec°"^ty F~°"°~
Name, TRie, and add~ess of executo~, atlmin~siratoi, or pe~son ~n posSesLOn of deCeOenYS D~ODErty
MARJORIE N. LoFURNO, Surviving Spouse
Name and adtlress of atto~ney fo~ estaie
DONALD B. MEDALIE, 201 S. E. Second St., Fort Lauderdaie, Florida
11 eslate is Dem9 atlmimsle~ed g~ve title and location of court and date of appomtment aS representative
~1o administration in F].orida
The decedent left an Estate both w~thin and without the State of Florlda consisting of the following mentioned items of
,property, the amount set oppos~te each be~ng the estimated value thereof (show gross rather than net value. Deductions tor debts,
I~ens, etc., will be reported onry ~n a complete return in the eve~t one is required to be filed.j
Real Estate in Fforida (Give Iega1 description of all reaf property in which decedent owned an interest)
Lot .120.,_ _ RIDGEWOOD . GROVES, . Unit_ 5, Plat Book. 53,. _ Pag~ _ 74,
P11~?~~G. R4~t~~$. Q~. PiA~~~B~s . CQ~~Y~ . F~o~~d~?:. .~+Q~. _$~.QCk 11.
Unit. Twot , LAREWOOD . PARRe . P1~~. BGo}~_ .~0,. .I'ag~ . 5.~.. _5~... I,uC~e Countys
Lot 6, Block 171, Unit 12-A, Plat Book 11, Paqes 35, 36.and 37,
~ufilic Iiecoids ~ of St, Lucie~ County. All three of the 7 000. GO
~hQVe_ .de.$cxibed .real. .pmpert~r - was .held • ~oir~tl~ -~~th • • - • - • - ~ • • • • ~ • • • • •
MARJORIE N. LoFURN(), Su~~n~n9on~~pOa
ut~e~xheduie if necessary)
Tang~ble personal property in Florida (Copy Inventory attached) . . _ . . _ NOl1@ . _ _ _
Ati other Property Wherever Situate:
Rea~ Estate not F~or~da 6.94_~ _ S, _ Artesian . St. Chicar~o, Illinois 25 ~ 550. 00
.
Stock, bonds, hlortgages, n~tes, and cash . . . . : . . . . . . . . . . . . . . . . . . . . , . . 50~ 474. zl
Insurance on decedent's I~fe and Annu~t~es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ :19 / 571.96 _
All other property ~nciud~ng, but noi l+m~ted to, ~o~ntly owned 1 4~0.0~
' p?operty (other than ~eal estate) and Powers oi AppomtmeM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Transfers dunng de.eclent•s ~~~e . . . . . . . . . . . . . . . . . None
~
TOTAL 3~03.996.17
; Is Th~s Estate sub~ect to Federal Estate Tax Return? Ye8
~
~ I~IRRJORZE :i. LoFUR10 Surviving Spouse
~ ~ hereby acknowledge under oath that 1 have
~ (name of Executor as de~~ned on the reverse s~tle)
` ~ead ihe forego~~g report and that the statements there~n conta~ned are true and thrt. the sauM correctly diulose all oi the
4 assets of the decedent named the~e~n wherever Iocated to the best of my knowledge aRd bet1M:~ ~
~ \ .
i - • •
: .
t ~ -I-~.~- a - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `,r"~~ ~ /`t~ - ft ~ Surviving Spouae
~ (Date) (S~gnat re) ~~~~bi(Title)
State ot I11~110~3 ' ' " • - .
; County of COOk i ~ ~
~ Swom to and subscr~bed before me th~s the. y. . . ~ . _ . . . . . day of . , , . . , , . , , , 19. 7.2 . . . in the State and
i County aforesa~d. ~
t ..K~.~.~~(.~....t:'u~....1.~..1.`?.'.~.L
~ ata ~uOi~c - County Judge My Commission Expires :
i WARNING! Failure to comptete alt blank spaces +n the above lorm w,11 r ult i elaymg the issuante of the prop~r certi(icate. It inapplitabk
, or nonc snow •~NONE".
ONE DOLIAR IS'~.6A1 fee .equired iw the issua~ce of a norrtsxable tertificau.
i
3
t
e
~ RETURN TO:
I
; Donaid B. Medalie
F 201 S. E. 2nd Streei U R~n~
N. Lauderdale, Fla. 33301 ~~~X V PACf i~