HomeMy WebLinkAbout1667 •
i
C
-
.
/ t
. I:orAr DR-3ot -PRELIMINARY NOTICE AND REPORT ~ -
. REV.'3/2fi/i5 ~ 4814'70
- TO: ESTATE TAX fat1REAU, DE?ARTMENT OF REVENUE, TALLAHASSEE, FLORIDA. 32301 -
tN COMPLIANCE WITH THE PROVISIONS OF THE ESTATE TAX LAW OF THE STATE OF FLORIDA,
CHAPTER 198, FLORIDA STATUTES, NOTICE IS HEREBY GIVEN OF THE DEATH OF
pacedMt'f ttnt narr+e and m1ddN rnitur Oetedenl's rest name Gate of Death
Bernice A. Foltz March 9, 1979
Resi a domiei ) at time of death Florida Counties in which decedent owned real estate Decedent's social security number -
~+l ~ordeMfia Street, SW 297-42-4427
OH 44 20 St. Lucie
Name, T1tN, an0 aadress of eYecuto., administralo., a person in possession of datedent's Oroperty Pall! F, FO1tZ, StlrVlving
Spouse, 241 Cordelia St., S.W., N. Canton, OH 44720
Roy H. Batista, ey ey testa,
Naere snd add.ess or attwnev ro. estate ttorn , ,
Cleveland Ave., NW, Canton, ON 44709 L..
If .slat. K pNn~ admrnglered, true t~tN and iocaiion of enure and Baia pi appvintrrtiani is ssprtssnlstine Probate Court Qf Stark
County, Ohio, Case No. 107758,•Dock,et 95, Page 23, Kenton, Rio
The deoedent left an Estate both within and without the State of Florida consisting of the following mentioned items of
property, the amount set opposite each being the estimated value thereof (show gross rather than net value. Deductions for
debts, mortgages, and liens, etc., will be reported only in a Federal Return in the event one is required to be filed.)
Real Estate in Florida (Give legal description of all real property in which decedent owned an interest.)
Lot 26, Block 1479 of Port St. Lucie, Section 15, a subdivision
according to the Plat the_reof_, reo~rded in Plat Book 13, page 6,
'i of the public records of St. Lucie County, Florida. - _ .
' Above.pro~erty 3ointlY owned by Paul F. Foltz and
I
~ Bernice A. Foltz, his wife. - _ s . -2,500.00_ .
(Continue on separate schedule if necessary)
Tangible personal property in Florida . - - - - l~brie
r
All Other Proptuty WlarwK I:.
i ivided 1/2 interest in Lots 558 and 559, 27,000.00
Real Estate not in Fbrida NDl"t~l. IyantOn, . ~'110 - - - . - - - • -
Stock, bonds, Mtxtgages, notes, and cash . . . . . - • 6, 266 :00
None -
Insurantx on decedents fife and Annuities . _ .
All other property including, but not limited to, jointly owned 19, 138. 00
property !other than real estate) and Powers of Appointment .
Transfers during decedents life . . . . . . . . - - - • • - .None .
TOTAL S 54 904. 00 ~ ~4
Is This Estate wbject to federal Estate Tax Return? ~ FOR OFFICE ~
' USE ONLY
O
1. PAUL. F. F(3LTL hereby acknowledge -
(must W sgnW DY person OusUrylny under F.S. 19!.01 l2)I ~ i
under oath that 1 have read the foregoing report and that the statements therein contained are true 1980 APR - ~ AK
and that the same correctly disclose all of the assets of the decedent named therein whtq~etrpl~loc~tpd 9',37
= s.•.< - ~
to the of y knowledge~Sd belief _ FILE!! Alit: RECURppkU
...1Z~~~~.'1......V.~'.p.. „..•..SUrvi s e'. STLU~I-ECOUNTY.FLA. t~9
s,c fkii>;;~ .t ~tO R POITRAS
(Date! (Sgnaturel ~ ~ (T~,.~ ~ ~r,- ~ OI.EIIK CIIIQtNT CDlpt
Sot. of O~'l10 County of S I~IfI;iRfi VfRIF1:0
-7
Sworn to and strbsa" bef rrre this the ~•c~ .....day of . ~ . ~ ~ ~./?t~`r'(1fy 481
• tl»s .ea ; ~ 4'70
~
t ' oeD 'cojmrission~ expires : ;A; ~ .
WARNINGI Fai ore to complete all blank spaces in the above form will rewlt irl rssuinte of the
proper artiticate. If none show "NONE." FIVE DOLLAR (55.00) fee required for the issrta~e of-a NontaxabN
• ~ 328 PEE 1667
Certificate.