HomeMy WebLinkAbout0743 _
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.]c,ntfy Keld Property ~ Vihie .
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Transfers within TWO YEARS Prior to Death
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That at the time of death then was no safe deposit box registered in decedent's individual name, or jointly with. or as agent or dcpuly of j
another. or in decedent's individual name. with right of access by another as anent or deputy. with thr exception of the following: ~ ~
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NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEFOSIT 80X RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAM F. OR NAMFS OF HOLDERS TO DECEDENT
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i BENEFICIARIES
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AELATIONSKIP AGE OF LIFE ;
Si; RVI V ED
'r BENEFICIARIES AND ADDRESSES (it ate hildren or "TENANTS OR INTEREST OF
~ DECEDENT ~
~ (State full names of all and their addresses who hav illegdimate children ANNUITANTS BENEFICIARY ~ f
STATE YES
an interest. vested. contingent or otherwise, in estate.) are involved. get OR NO AT DEATH OF IN ESTATE f
forth this fact.) DECEDENT ~ i
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