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REV.°2~ 5 P''LIMINARY NOTICE AND RE~ ~RT
TO: ESTATE TAX 9UREAU, DE/ARTMENT Of REVENUE. TAL~AMASSEE, F~ORIbl1, 3230~
IN COMPLlANCE WITH THE PROVISIONS OF TNE ESTATE TAX LAW OF THE STATE OF FLORIOA,
CNAPTER 198. FIORIDA STATUTES, NOTICE IS HEREBY GIVEN OF THE OEATH OF
o~cw~nt•s hnt nam~ ana m~ooN +mua~ o~c~aeoYs ust nam~ Qste of Death
Fiorence H. Oifenther December 20, 1977
22~qs~doQyt k)~~(q~e~e~aCe Florida Counties in which detede~t owned resl sstate Deoede~t's social security number
Lauder6i 1~ F o~la 33313 Broward snd St. Lucie 095-16-4577
NarM, TItM,-MW adCr~sf o1 ~xKUtw, sdmi~btrato~~ a p~rwn in posf~ssioe~ 01 ~cWenl's property
Harold OiYent6er
PIartN and Wdt~ss Of attO~n~y fw Ktatf
john A. W. Camilto. 7457 N. W. 4th Sireet. Plantation, Flori~de 33317
~sut~ b oeiey admin~st~reO. qiv~ t~lM inO 1o4t~o~ of Court ~nA dat~ 01 sDDO~ntmMt ~s rePrlsf~lativ~
Th~ deoedent left an Estate both within and wiMout the State ot Florida consisting of the tollowing mentioned items of
property, the amou~t set oppusite each being the estimated vatue thereof ~show g~oss rather than net value. Deductions for
debu, mortgages, and liens, etc., will be reported only irt a Federal Retum i~ the event one is reguired to be filed.)
Rea! Estate iA Flo?ida (Give iegal description of all real property in which dectdent owned an inte~est.)
._I.~q~_11. Blo~~_ 1 Gaet]~e Gardene,. No.. .1~, accordin~ to the_Plat thereof
.
ae reco~ded . in. Plet, Book 66R _ pege. 2 oi Public Recorde oi $roM?ard
County, . Florida, _AND Lot 10 Blocic 1521_ of .Port_ St. :Lucie_Section 29
__~ccording to the,Plat.thereoi in Piat ~ook 14_ page. 8 Pubifc Recorde
- -
_ofSt. Lucie, County. Florida s 33t000:00.
(Continue on separate schedule if necessary) .
Tangible personal property in Florida 1~~• ~
_ .
All Oth~r PropsRr Whw~wr Sitw»: -
RealEstatenotinFlorida ._...b~.~•.~_
Stock,bonds,Mortgages,notes.andcash...........••-•-••--....-•••••--•-•-••---•._... ...-••--.~Q~....
Inwranoe on decedenYs lift a~d Annuities . . . . . . . . . . . . . • • • - . . . . . . - • - . . . . _ . . _ . _ . . . . . . : . . . _ . . _ . 2~ .
All other property inctuding, but not limited to, jointly owned
property (other tha~ resl estate) and Powers of Appointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . _ . . zi_~~•.~ .
Transfenduringdecedent'slife ......._~0'_....
• ~
TOTAL S 44, 0~. ~ ~
FOR OFFICE Vj~
k This Estate wbject to Federat Eswte Tax Return7 NO.
r, USE ONLY
t; Harold Ot[enth~er hereby acknowledge
' _[must W si9Md Dy Mrsoo qusllfyfey ur?d~r F.S. 196A1 (2)] ~
~mds?,oethj~?~ 1 heve ~ead the foregoirp ~eport a~d that the statements therein contained are true ~
~d tti~t t~ sams correftly disdose all of the assets of the decedent named therein wherever located
to thayest bt A~y know belief, -
..r jan~.Q,.~.157.$ . . . surviv~qg epous
lD~u) ISipna urel . . . .(Titlet . . . . .
9~. ~i..: Flo~ida ca,~tY o~ Browsrd
.
9wan )o aubsor~b~d b~tw~ me this th~ . . .9t~- • - • • • - • day of . ~aQUSl^y. . . . . . . . . , 19 .78. . . . . . in '
tbt ~ County ator~sid. .
. ~ . . . . . . . . . . . . . . . . . . . . . . . . ."qT!1~1~ ~1J~lIC.StATE ~ ~LO~iDi11 AT LARGL
, , ry ~°e"~---~~ ~ ~ R ~g5 ~ ,~8
oompMte a!1 blank ~r;
WARNiNGI Failun to M~~p~y~ng the iswance of the
proper certificsc~. 1/ nooe thow "NONE" FNE DOItAR (i5.00) tee required for tAe issuance ot a Nontaxabk
Ce~tif~cate
_'.S~i'~ t~# 4.ri~ E £ .-s " " _ ~ . . . .
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