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FamOR 701 PRELIMINARY NOTICE AND. REPORT 48345 ~
RE V. 3126/75
' TO: E=TATE TAIL BUREAU, OEIARTMENT OF REVENUE, TALlAl1ASSEE, FLORIDA, ~2~04
IN COMPIiANCE 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
pecedent't rlrst name and midON IMtisl OKadtM's ust warts Date of Death
Mildred M. ~ Walsh May 6, 197s
Residence (domicile) at time of dwth Florida Counties in which deoedertt owned real estate Decedent's socisl eea,rity number
Wheaton, Illinois St. Lucie 357-OS-1445
Name, TttN, and address of ex«utor, adm~nitt.ato., or person In oossss~on or d«edenYs orooerey John J. Walsh, being in
possession of concerned property, 1399 Parkhill, Camarillo, CA 93010
Nam. and address o/ attorney Ior slat.
Jollo<1 H. Sutherland, P. 0. Box 100, Vero Beach, Florida 32960
tr state u t,NM admtMStered. sure lttN and toution of court and date o1 appointment as reprsentative
The decedent leh sn Estate both within snd 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 EsUte iA Flofida (Give legal destxiption of all real property in which decedent owned an interest.)
Jot. . ~l~Ck. 79 Q~. tau?. Ri~e>~. Estates,. ,chit •~9, . a subdivision .
,at<~o~rding. to , the plat. thereof -recorded in .Plat .Book 10, _ page _ 74 , _ . .
. .
of• the-public_i~ecords. of St._ Lucie County, Florida. _
. . . .
. above pxop~rGy. jQ~1G~y. caned ass . per. Warramty. Deed - aatea........ .
October'. 25 , .1969, .executed by. Fraancis W.. Baker .unto .John J . Walsh s. 2 ,000: 00
and Mildred ~,,~lsh~ hi otttin a ufe ii n
wife, record Nw.--Zl,196~ i.n ~.~'.~oo'~c 1, pagee~~I.yl S~o.i~e None
Tangible personal property in Florida . . . . . a'. -
al oeh.. Proptttrty wh«ew. sit~l.t.:
Real Estate not in Fbrida - - - . 75, 000.00. .
Stock, bonds, Mortgages, noces, snd cash ......None .
Inwrartoe on decedent's life and Annuities . ......NOLl@ .
AI! othtr property- including, but not limited to, jointly owned
property bother than real estate) and Powers of Appointment .
e....--
~ Transfers duri decedent's-life _ .....Nestle .
ng
j TOTAL S 77,000.00
' Is This Estate wbject to Federal Estate Tex Returni' ~ FOR OFFICE
JOHN J . WALS1~ USE ONLY
I, hereby acknowledge -
[must w synod or o+rson Quatttytns under F.S. lsa.ol (211
under oath that I have read the foregoing report and that the statements therein contained are true
and that the same correctly disdose all of the assets of the detxdent named therein where located IgoO APR 18 A,
to the best of my knowledge bet- Person possessed o~ , ; I : 2 I
r3.: 7. ~ . .~~-~~-...decedent's .~'Op~'~'......
FIIEC SKI` CUr-vi i~
IDate1 (Siena el ITitlel ST.IUCIECCUYtY.fIA.
ROf3Efi POITRAS
sated C~'Z1~R1~lIlsl county of t' Ventura ftLERK CIRCUIT CCURt
i
Sworn to and aubsuibed before me this the /Lh....... dsy of ":.if arch is - - $0..... rn R~rsre *'ERlFIFO•`_~~
tM Strie County for . -
- - ~'D~ 4834'75 .
' t::,; ~,i,n~ = My - co~linas sioYi • mtpites : - 9-10-83
WARNINGI Fsilure to complete all blank spaces in the shove form will rewlt in delaying the issuance of tM
proper certificate. If none show "NONE" FIVE DOLLAR (35.00) tee required for the iuuance of a Nontaxable
94t CA ,e-~~~
i Individual) ~TiTI~ IN5U1tANCE
AND TIil15T
STATE OF CALIFORNIA x.rconao,~r~a.
Ventura ~
COUNTY OF - .
March 7 1980
On- _ _ _ _ _ before rrie. the undersigned. a Notary Public in and for said
state. personally appeared-_ John J. Walsh
W
W
_ .known to me
W
a to be the persort_ ____whoce name- -subscribed
~ to the within instrument and acknowledged that---- he__ lN~~•••wm"mmw"w"~"w~~w'~ f
~ txecuted the same. i ~ ocrM~u sr~~ / ~
WITNESS my hand and official seal. ~ SARAH J. FUNK
f10tARV vueur_ cu~FpRNU /
0 pn+wc;~Pat cxrtcF iN /
~ yEr~sua,?cour+rv /
Ylf Comrrws-,an Esp Sept 10. 19x3 /
Sigmlure " ~ssee.sse.s.f~seewsmmwmwe.sMJ
era un - _~OK`2`~ nsr+[~ X2'7[1