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liMiNARY NOTICE AHD REP~tT
REV- 3J28/75
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• ~O i ~ ~ ~ " ~ EiTATE TAX /tN1EAt[, OEfA11TMEMT Of N11i TAL4AMAtREE. fLiflR1OA, 3>t~ ~ ~ .
INCOMPLIANCE WITH THE PROVISIONS OF THE ESTATE TAX LAW OI` THE,STATi£ OF ~LORIOA,
CHAPTER tsi8, FLORIpA STATUTES. NOTICE iS HEREBY GIVEN OF THE DEATH OF
pgdawt's lint eMna and mi00N Initial OatWanY~ tall wanr Oea Of Oaatl~
lR71~i» C. >PLat><N3R Movrgbst S, 1979
1 ti of Fbride CAUt)tiN in rrhidl depdtnt owned raN estatt Dat~drnt'a aOCial t.ciirlty number
3 a$~s+re - ~ ~ 1lZ--41-2927,
Ft. •
TItN and addraw of ~xotutor. aidnlMitpatOr. of OMiOn Mi OoIMMI~ of daoaant"~ Oro/Mt1?
ilsl~ K. p~ots>r~!'t ~wtvirinq asponN, 3300 1ti 3i • BtYwl, 11pt • 1222
Naar and aedra~s of NtornaY fp astaN
g~ RgOt?TQRD -
11 ottau N bMM aMMwtttan0. ~ tilN and location o/ cowl and date o1 aOpWntew~t as ?apnlantatlva
'1'~g>R'R L 1/O ~1QIIETS'1'ZI]?sldt ~ ?CIS S~1'1TIi -
TM deosrMrtt Nft an Estsu both ttlldliD and widlotlt the State of Florids.oonsisting of the following mentioned items of
property. the amount set opposite eedl being the estima'ed value thereof lshottr lots rather than net vshle. Deductions for.
debts, mortgages, and tieln, etc., will be reported only in s Federal Retum in the event area is ntquired to be filed.)
Rest Esnts iA Fkxids 1Give legal description of all rest property in which dsesdent owned sn_intere:t.)
. ~p~~~')i!!! . ~1?~tilCCilMRY1.l.. UA~t . ~~i?~ . tom. ~:O~F11L..$T11aE .'IYJRRB$~.... .
$~!S? looatad at .3300 M. E. 36th Sts~t, Ape. 1222,
•F st•iia 3 08;-...x....... OS, 000.00
Ir4~0 . a. . D 1S . Al' UZLi .lZ., . La1>~IDOQ .PIf,B>~ oa
MAP 12/12>~, of St. Lno~i County, lrida c
t 5, 000.0
(Continue on separate sdleduN if rlecesssryl .
w
Tangible personal property in Fkxids
~ ~ ~0 fEB 18 All i~ Oi >~t ~
ReslEsnu not in Fkxida
,
Stock. bonds, Mortgages, notes, and cash . . . f~LEO~ FECOROEO _ 1115-
3, 'M: F`A:
R PaTRAS _ 6, 000.0 -
Inswsnoe on decedent's life and Annuities . . • CLERK CIRCINL - .
~ All other property includiltg, but not limited to, jointly ov~*D 4'ERIFtEt]_
property lother than real estate) and Powers of Appointment ~ Q4~.~~a. 3.~. .
Transfers during deoslient's life ~!rvVa7~7.......... ~10!>~TB- - - . -
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TOTAL s 162,738.31 dp 3
I: This Esnn subject to Federal Esnte Tax Returnt NO FOR OfFi1CE
U!E ONLY
1, Blisab~lth ~i. pl~tsa~r hereby acknowledge
[aiurt tlNrd t?t? trrson auaufrlns urea. F.S.1liAl [2)1
under oath that 1 here read the foregoing report and that the statements thereia contsirled are true ~
' taondt~that tM same eorredly discloa all of tM assets of tM deosdsnt nantsd'therein itrftersver kxsted ~
1--! ~of my k and ief~,/ ; ~ - , ' ~
~lOatal• (Siontmnl ~
sYste dt Florida ~ $ ..•~8~~~~.:~ _
n to aubnsibad baton rile this tM 4 day, . ~ . ~
~ -,~80 In
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Notary PupNC - CNCUIt . . . ~ ..1~3
I INARNINfiI F ' to oanpNta all blank tpaas in tlr _ na ttia iuuanoa of rile j
props artifieaa. If rear show "NONE:' FIVE DOLLAR (=S.o01 tae' lit blutnce of a NontaxabM 1 ~
Cartif ~ .
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. RETURN TO: - +a t~~TMR~
oR~
WATT
JArtS~N ~ De GAKCE, P.A. ~
2'!01 E. SUNRII~ BLVD.
SUtfE 212, SUNRISE BAY BUILDING -
FT. LAUDERDALE, FLA. 33304