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AFFIDAVIT OF EDITHE SAMANCHIK ~ ?
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STATE OF NEW JERSEY ?
COUNTY OF pASSAIC ~
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Before me, the undersiqned Notary Public, personally ~
appeared EDITHE SAMANCHIK, who upon her oath says:
1. That she is the surviving spouse of WILLIAM G.
SAMANCHIK who died on July 11, 1974, as indicated by the certified
copy of death certificate which is attached hereto, marked Exhibit "
"A" and made a part hereof. ~
2. At the time of the death of said WILLIAM G. SAMANCHIK, ~
your affiant and WILLIAM G. SAMANCiiIK owned real estate in St. Lucie ~
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County, Florida, more par.ticularly described as:
Lot 8, Block 1 of SOUTH PORT ST. LUCIE,
UNIT ONE, a Subdivision according to
the Plat thereof recorded in Plat Book +
12, Page 2 of the Public Records of St. ~
Lucie County, Florida; ~n~ y_(> p0 ~
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as tenants by the entirety. ~
3. The marriage of your affiant and WILLIAM G. SAMANCHIK ~
was continuous and without interruption from the time of acquiring {
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title to the real estate described above until the death of WILLIAM
G . SAM~fNCH IK . - 3
4. The Estate of WILLIAM G. SAMANCHIK was not subject to ;
Florida estate taxes, as indicated by the Florida Non-Taxable Certifi- ~
cate attached hereto, marked Exhibit "B" and made a part hereof; and ~
all Federal Estate taxes have been paid in full, as indicated by a copy ~
of the Internal Revenue Service Acceptance of Estate Tax Return, to- ~
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gether with evidence of payment of the tax, which is attached hereto, ~
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marked Exhi.bit "C", and made a part hereof.
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' EDITHE SAMANCHIK
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Subscribed and sworn to before me th' o?c,/ day of ~`'~i~9;75. ~ :
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Notary Pu c ' ' '
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(Notary Seal) - -My commission expires: " Y
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THs instrumet+t was pr~eparod b~l
' ~QOxz~ P~E ~ BO(Nf~~ PA6E~~ THOMAS H. THl1RLOW. JR.
g ESECL`TI~~E YL:1ZA
P. 0. Bw~ 1a6, Stuarf, F{orida 33444
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