HomeMy WebLinkAbout0207 . •
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j - .-S~~ DG'/~J O~C~.'v
Fo?m DR-301
Rev. ) 0-O 1-73 ~V,~~O
PRELIMINARY NOTICE AND REPORT ,
TO: ESTATE TAX BUREAU, DEPARTMENT OF REYENUE. TAILAHASSEE, FLORIDA. 323W ~
IN COMPLIANCE WITH THE PROVISIONS OF THE ESTATE TAX WW OF THE STATE OF FLORIDA,
CHAPTER 198, FLORIDA STATUTES, NOTICE IS HEREBY GIVEN OF T!~!F nEATH OF
Decede~l's I~nf nart?8 and midtlle initial Oetede~t's last name Oate of dQ~th
SALLY W. BALLOU May 22,1972
Dscadent ownsd real aropeetr in
Residcnce (domicile) at tims of deatA
Fort Pierce , Florida St . Lucie co~~tq, Flwida
Nart», Titl~, and addreu of sxecutor, admimstratw, w person in Oossession o1 deceAent's property
Fred V. Ballou - Surviving Spouse -~11 - 3rd Avenue South
St. Petersburq, Florida 33701
Name and atldreis ol attorney tor estate
William N. Graham, Esq. - 925 Freedom Federal Bldg., Tampa, FL 33601
If estate is bein9 adminisfered, give title and location of court and dste of aDOOi~tment as represantat~ve
Not applicable
The decedent left an Estate both within a~d without the State of Florida consisting of the following mentioned items of
E property, the amou~t set oppusite each being the estimated value thereof (show gross rather than net value_ Deductions for
E debts, mortgages, and liens, etc., will be reported only in a complete return in the event one is requi~ed to be filed.)
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~ Real EsWte in Ftorida (Give legal descxiption of all real property in which decedent owned an interest.)
; Lot 1, Block 3, LaFOND SUBDIVISION, as per plat
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~ thereof on file in Plat Book 8, page 12, of the
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; _ _ . _ _ . .public_ _records. _of .St.. Lucie County, Florida
; _ . . _ . _~t . full . value _ based. .on _ sale_ _price
~ S ..17.t500.00
~ (Continue on separate schedule if necessary)
personal effects 250.00
~ Tangible personal property in Florida (Copy Inventory attached) . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . _ _ . . . . . . . _ . .
~ All Other Property Wherever Sitwu: FtLEO Ay:~ nECORDE~
~ St. LUCIE COUMTY FLA.
~ Real Estate not in Ftorida . . . . _ . . ROC ~R P~~T~AS ~ NONE _ . _
CLEPF.'C~~~Ct1tT CONRt • l -
RECOR~ VER~f!E0~
~ Stock, bonds, Mwtgages, notes, and cash • • - • • • • • • • • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ . . . . . . . . . NONE . , .
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~ Insurance on decedent's life and Annuities . . . . . . . . . . . . . . . . . . . . ~ . . ~ 11i1. . . . . . _ . . . . . . NQ~1~i . . _ ~ ;
All other property including, but not limited to, jointly owned
, NONE
property (other than real estate) and Powers of Appointment
3
o~a~o NONE
Transfers during decedenYs life
TOjAL S 17,750.00
Is This Estate subject to Federal Estate Tax Retum? NO
BdllOtl `,s~:. . ,
Fred V. .t
I, hereby acknowle~+ge under oath•t f:) • y~
~muit be sig~ed Dy petson quali/ying under F.S. 198.01 (2)j ~~~~i ~ ~
; JO
read the foregoing report and that the statements therein contained are true and that the same correctly d%k~ th~-
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assets of the decedent named therein wherever located to the best of my knowledge and belief. . ~ ~
- - . March 6 , 19 75 ~ S~'~3~~: SP~ ' :
f°.:: . . ' ' ' ' ' . . . . . . . . . ' ' ' . . . . . . . . . . . . . . ' ' ' ' . /La~ -
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r'K IDatel i~ (Tiite} ~,fie`~
- State of Florida ~ " ~ ~ ~ 10 ~ '
co~?,ty or St . Lucie % - : "
;,',y
~ -.--....,ts--n--•----. ~n;nestSyg~l't~/ J_Tt`~
Swor~ ro and subscr~bed be(ore me th~s the . . . . ~t~1. . . . _ . day oi . . . Mt~~ .h 75
, ; afwesa~d. lLQ ~p~~~Y~ "
~~'er Notary Publi~ c l ~`i~. . . . . . . . . ~ . .
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WARNING! Failure to oomplete sll bt~nk spaces in the above form wilf rewlt in delayirg the issuance of the proper oertifiate.
If none show? "NONE": .:'T: -.~~•~r c_ t~ ^v" fiCR!9A AT lAR3E •
- FIVE OOLLAR 1s6-00) fe~ rpuirM fo~ tM iswant~ of s ~on•tsxaM~ catifieat~. cf~s. 7. 19T7
.Uh.~_'v i~:F.U ~E:~::f.A: ~i~iliRANCE UNDERWRITE~S
so~237 ~ 206
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