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Form DR-301
R". PRELIMINARY NOTICE AND REPORT X9310
9
TO: ESTATE TAX BUREAU, DEPARTMENT OF REVENUE, TALWHASSEE, FLORIDA, 32304
INCOMPLIANCE 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
Wctdent's first name and middM initial Decedent's last name late of death
John M. Spratt July 8, 1978
Residenp (domicile) at tlme o1 death Decedent ownW real property in
1796 Cumberland Rd. , Cleveland Hts. , Ohio 44118 St. Lucie county, Florida
tWme, TitN, end addre~ of executor, administrator, Or person in possession of decedent's property
_Lynne E. Spratt,~1796 Cumberland Rd., Cleveland Hts., Ohio 44118 -
lvame and addreu of attorney for estate ~
None
11 estate is being adminiftered, give tltla and IoUtion of court and date of appointment ss representative
No Administration
The decedent 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 complete 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- 35,- -Block- 1500_ of- Port- St. _ Lucie,. -Section _ 16.- . - _ - -
Lot 36, Block 1500 of Port St. Lucie, Section 16~.
I' Lot 34, Block 1500 of Port St. Luc;e,,--Section 16. $ 3,185.00
j
k _
' Charlotte County~Property ($4,700.00) S 7_,885._00
(Continue on separate schedule if necessary) ,
Tangible personal property in Florida (Copy Inventory attached) ! _ _ . , NQX2e - , , _ . _ _
All other Property Wherever Situate:
Real Estate not in Florida ~ 7 ~ ~ ' 1 . - . - - 30,,.000, 00,
Stock, bonds, Mortgages, notes, and cash . S . E A R 0 _ None , - , _ , - - _ _
~ _ ~ ~A....
None
Inwrance on decedent's life and Annuities IXEiK -
All other property including, but not limited to, jointly owngl[CORO VERfi'1E0
1 property (other than real estate) and Powers of Appointment ~f NOne
~ Transfer during decedent's life 4~3Z09 - - - . .None......... .
` TOTAL =37,885. QQ_
Is This Estate NO ~~`:~+i .
subject to Federal Estate Tax Return? -
I, Lynne E. Spratt ~ hereby acacnowledge under tuEtF~"
t'i~t~~`
[must be signed by person qualilying under F.S. 19S.01 (2)1 ` ` 'r'1: .
• read the foregoing report and that the statements therein contained are tr and that the same correctly dixloyE: ,~(:,o~ tfia ,
~
assets of the decedent named therein wherever located to the best of my ledge and lief _ *
(Date) - (Signature) (TitMt) •,tr. -
state of Ohio - ~ ~ ~ . _
county of Cuyahoga
Sworn to and subscribed before me this the 5 ~ day of .~y 9 •80 i he State end ~iYiitj~: s
aforesaid.
lit- rcutJ
WARNINGI Failure to corrtpkte aM blank spaces in the show form will result in delsyirg the issuance of the proper certificate. II none
slaw "NONE".
- WILLIA!W V. ,•hL~J, f~t2Vrll~.J
FIVE DOLLAR 13fw00) fee required fa file is•wattn afi anon-taxable a.tifiate. NOTARY PUSI'C • STATE OF OHiti
nw~~ filY cplatnisian Cis co saDin2lon data.
BOOK ~AG~ sul~o..:a-?3 R.C.