HomeMy WebLinkAbout0092 Form DR-301 ~ ~ `
Rev. 10-01-73 pREIIMINARY HOTICE AND REPORT 3~~'~~8
TO: ESTATE TpX BUREAU. DEPARTMENT OF REVENUE, TALWHASSEE, FLOAl0/1. 3?30t
IN COMPL{ANCE WITH THE PROVISIONS OF THE ESTATE TAX LAW OF THE STATE OF FLORIDA,
CHAPTER 198, FIORIDA STATUTES, NOT{CE IS HEREBY GIVEN OF THE DEATH Of
Oecedent's ~ust name antl m~ddle ~mt~al OeceAent's Iast name Date p/ ~it~
1~AAGABBZ I. TOxESKAti Aptil 1S. 1976 ~
Res~de~ce (tlomicde) at Ume o( cltatb Decedent owne0 real prope~tY m
3t. Luci~ Mobila oillag•
8t Lnci• ~o~^ty.F~a,a+
Name, T1u~, sna sOdreu ot tx~cuto~, aominntrsta, w oer~Aldbo~S~csbwUl ~qni4.plqp~tyTD R~•: EY
505 htpRTHEAST 1251ri STREET
~iiillia~ ts~o~ tor~s~aa C~Q N~RTH MIAMi. FLORIDA :~:~161
rvs~.~e,~a aaa.ess or ~e~o.~er ~or esi~ie PAUL H. LAUFER. P. A. AITORN £Y
S05 NORTHEA$T 125TH STREE7
NORTti MIAM1.'~~R~c~ a~a161 - .
If eslate n De~n9 adminntered. 9ive tdle and IocaGon of court antl tl~te ot appo~~lment as rep~ese~tsFve
not adminiattrad
The decedent left an Estate both within and without the State of Florida consisting of the following mentioned items af
property, the amount set opposite each being the estimated value thereot ~sfiow g~oss rather than net value_ Deductions for
debts, mortgages, and liens, etc., will be reported only in a comptete return in the event ane is iequired to be filed.)
Real Estate in Florida ~Give legal descriptio~ of all real pruperty in which decedent owned an interest_)
- - • - - - - - - ioc . 3.2,. .Biock _ B_ .o~ _ AQO~i _ KA~Q$. _~O~~IQ~~_xQ~. - - - . . . _ . . _ . .
. . . . _ . _ _ . D~IIT. NO.. _ OH8_.. _ accordin~ _ to . th~. .plat_ t6~~aot,
------...recor.ds~d.i.A.~la.t.aoo.k.~,6..+~t. p!a*_.19._of._the.--.--.-----
- - • - - - • - - .~uk1~.C. ~s~e.osd~. .Q#_ : , Lucie. .CountY,. .Florida . - - , - - - - - -
S 5,5.00...00._
(Continue on separate schedule if necessary)
Tangible personal property in Florida (Copy Inve~tory attached) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ .~1~II~. _ _ . _ .
All Otfia P?operty YYharever Situat~: r ' , s~
ST...~..: : :.,hf~itA . -
Real Estate not in Florida . . . . . . . . . . . . . . . . . . . . . ' . _ . " a.~. _ . . . _ _ _ . NO~IIa. . . . . . . .
' ti •ti'v~. GLi1R"
Stock, bonds, Matgages, notes, and cash . _ . _ _ _ . . . _ • : . . f"v,~...,r.....,..- . . . . . _Nt1IIA. . . _ _ . _ _
I~wrance on decedent's life and Annuit~es . . . . . . . . . . . . . . . . . . . . . !.Y'~(. . .~?.p~.~q~. . . . - - . -Noaa_ . . . _
M~n ~ ~ ~
All other property ~ncluding, but not limited to, jointty owned
property (other than ?eal estatel and Powers of Appoi~tment . . . . . . . . . . . . . . _ . _ . . . . . . . . . . _NQA*. . . . . . . .
3~~8~i8
TcansfersdufingdecedenYslife ••--N~tl!_.._....
,
TOjA~ 3 S.S00.00
Is This Estate wbject to Federal Estate Tax Return? NO
1, WILI.IA~I LERA4 FOflE3~iwN hereby acknowledge under oath that I have
(must Dt slqnea Dy person qwUlyinq unaer F_5- 198.01 (2)1
read the foregoinq repDrt and that the statements therein contained are t~ue and that the same cor?ect{y disclose atl of the
assets of nt named therein wherever located tp the best of mY knowledge and belief_
~ % .
.02 LL~.~a.,.~---~.t6-~ .-~!/E•~~d-~~.cc.c......Per.sonal•Rap
.
40at (5~gn ure! IT~tlel
Stateot t ozida
COUnry ot Dad~ , j . /
~ . . _ . . . . day ol . -"/4 r • - - .1. . . _ - 19 ~ - - . . m the State and County
5worn to and subscnb~ed belore me thK the
aFwesa~d. ~ _ ~G- .
~sl~Et.c:.'.
_ , . - ~ ~VOtsr
WApNiNGf F~iiure to oomptele all blank spaces in the ~bwe twm will rewlt in delayirg tM isswnoe of the proper oe?tHicate.
tf no~t show "IIIONE":•
FIVE DOLLAR (:6.OOj iN ~puir~d fo~ the nsusnce of a non-axaW~ c~.of~cat~. ~OtARI PU6tIC StAfE Qf FeORfD11 AT IhRCf
. MY toM,N~551oN ~YPIR~S lA~l 10, 1q-q
~ONOED THRU G~NfRAI It:cURsr.:E ll~-
~^,~r2[).~ ot.r.t' - . -