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HomeMy WebLinkAbout0258 ~ • . . ~~494;~ ~ . ~ AFFIDAVIT OF MAB.F.L M. HINTZKE . ' _ STATE OF FLORxDA ) Z ss: COUNTY OF MARTIN ) BEFORE ME, the undersigned notary public, personally ' . : appeared, MABEL.+I. HINTZKE, who upon her oath says: : 1. That she is the surviving spouse of THEODORE J. HINTZKE~, , ~ who died on January 20, 1974, as shown by the certified copy of ~ f the death certificate which is attached hereto, marked Exhibit ~ "A" and made a part hereof. . ' 2. That the time of the death of said THEODORE J. HINTZKE,; ; your affiant and THEODOR~ J. HINTZKE, owned real property in Martin County, Florida, more particularily described as: (See Exhibit"AA" attached hereto and made a part hereof.) 3. That the marriage of your affiant and THEODORE J. ~ HINTZKE was continuous and without interruption from the time j of aquiring title to the real property described above, until ; . ; - the death of THEODORE J. HINTZKE. ~ 4. The total value of all property which THEODORE J. ~ HINTZKE, deceased, had any interest, including jointly owned i property, insu-rance or other property including his gross estate ' ~ for Federal Estate tax purposes, was over $60,000.00; that an ' ; acceptance of an estate~ax return, form L-154 issued by the De- ~ ~ partment of the Treasury is atfached hereto, marked Exhibit "B", and made a part hereof; that the Department of the Treasury form ~ 7990, United Estate Tax Certificate of Release from personal ; liability is attached hereto, marked Exhibit "C", and made a ' ; . ~art hereof, and State of Florida Department of Revenue Form ; ' DR-302, Non Taxable Certificate and Receipt for Estate Tax, No. ~ ~ i ` D-40083, is attached hereto and marked Exhibit "D" and made a i , • i part hereof . - ' ~ , i ' v~lGJ2~ ~ 1' 1 I: ~ ` 1 ' - MABEI~ M. HIN ZKE ~ ~ SWORN TO AND SUBSCRIBED before me this S/Sfday o~ January, i i - I, ~ 1978. . . - , E ~t ~vb r~~c. n99 ~ j , K~_`:~.Ei:v 2k ' - ~ ~ ' ~\//1,~ ~ ,;:iA~•.i. _.a ~ . . _ ~ G'^ ~I J/, {///J?`I-~ ~ ? { ~ ` ~ : ~ ~ r-~` - ~ : _ ~ NOTARY P BLIC- . uvs I' - - ~ (Nota _~a1) ~ ~ M co~aission ex ~res : ~ 2 Y P ~ 7 f i ~ . . . ` 0 R /?'I ~ 4~~ / ~ ~cS 80C'!f ~ PAl~ z~ t~t Lod~ Oo~4 i • 4 _ ~ _ . _ _ _ _ _ - _ , .