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_ ~ ~ ~ 4~'4'~'94
_ iN~ THE CiRCViT COURT FOR -
SA~P I~lCIB COUNTY, FWRIDA
iN RE: ESTATE OF ~ °.°.~BATE DIVISION
• Cr
~ H. G~POOIC, Csse No.: 79 217
Deceased
• rETIT1aN FOR pISCNARGR - - - -
The undersigned, ss personal representative of the above estate alleges:
1. The decedent,. CART TSTR H. GIffiiS~ImaC , a resident
of Carty, Flol'~C1d ,died on
- _ 19~ ,and Letters of Administration ware issued. b
Petitioner on 1!Sav 14 19.x. .
- 2. Petitioner files herewith - a ~ final accounting containing a: complete report of all
receipts and disbursements since the co~unencement of administration of this estate, or
since the date-of the last periodic accounting filed !herein, if any, or waiver of the filing and
any hearing ~ the same, sued by all interested persons, are attached hereb.
3. Petitioner has fully administered this estate, by making payment, settlement,
or other disposition of all claims and debts that were presented, and by paying or making .
provision for the payment of all expenses of administration.
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d. Petitioner has filed all required estate tax returns with the Internal Reven~~e
Service and with the Department of Revenue of the State of Florida, and has obtained and
filed. with this court evidence ot. the satisfaction of this estate's obligati- I
Florida estate faxes, if any. -
5. Petitioner has made or proposes b make distribution of the assets of this estate
as set forth in the schedule of distribution attached hereto as Exhibit /l
6. The only persons having an interest in this proceeding and their respective ad- _ -
dresses are: _
. Z17eLie are m -other , other than
Petitioner, havirxr an interest
in this p~ooeeding.
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