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CI.ERK CItt~U{i COUE~ i PR08ATB DIVLSION
IN RE: ESTA1'E OF " ~
~ N~~ 78- CP .
CLIFFORD W, s~s, 5 2 9
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~ - PETITION FOR ADM~iISTRATiON .
(Florida Residcnt Wtth Will - Single P~etitioner)
,The peNtioner, GLORIA A. SAI~Il~lIS ~ ~ ~j~:
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l. PeHtionar has an inte~iest in the alwve estste as residuary beneficiary and
- ~ designated personal~representa~e.
Petitioner's name and address are Gloria A. Sammis, 128 EverQlades Boulevard,
S~uart. Florida s3494
and the name and address of petitioner's attorney are as set forth at the end of this petition.
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2. Decedent, Clifford W. Sammis , whoee isst known
; 128 Everqlades Blvd., Stuart,Fla.. on September 14,
78 Martin Memorial Hos ital '
k , 19 at p , and at the time of death
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" decedent was domiciled in St. Lucie County, Florida.
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3. So far as i~ kt~own, the names of the beneficiaries of this estate, their addresses and
relationships to decedent, and the ages of any who are minors, are:
NAME ~ ADDRESS RELATIONSHIP AGE
~ (BIRTH DATE
' IF MINOR)
_
~ Gloria A. Samnis 128 Everglades Blvd. Wife Over 18
~ uar , ori
Cliffotd W..Sammis, Jr. P.O. Box 2874 Son Over 18
z Steven~_ B. Sammis ~~~~ineCS~reet92921 Son Over 8
' Cd~1~r~C~ Fulton ~hg~~x 02769 Dat~Qh _pr nve,;_1R ~
? Stuart, Fla. 33~94 ~
? c o s. aro yn . u on
~ Virginia P. Israel p O Box n9~ Dauqhter over 18
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~ Stuart, Florida 33494
4. Venue of this proceeding is in this county because decedent -died a
' resident of this county. '
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~ S. Gloria A. Sammis '$h~
, whosc address is
~ bslow i
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' Form No. P-2l ~ ' - 60Ui~
~ ~~~~~979
~ On.Fw~w.er~9,s '
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