HomeMy WebLinkAbout1487 5.
That the nature and value of the property of the deceased, ~g~,~~ggg~
who died on tt~e 28th day of January , 1~~, as near as can be ascertained at
tt?e present time, are as follows:
Name of Institution Address Check One
Full ~
1. Deposits First Union National Bank, Canton,N.C 46.E
2. Deposits
3. Deposits
4. Deposits _
5. Stocks and bonds (including jointly held) _~~9~~ 0 Q
6. Cash and uncashed checks on hand
7. Household furnishings'- estimated market value _ 300.0 0
8. Interest owned in any business
9. Insurance payable to estate OOOj4~
10. Insurance payable to individual beneficiaries $
11. Notes and other debts due deceased -
12. Farm products, livestock and equipment
13. Motor vehicles - estimated market value
14. Miscellaneous personalty - estimated market value
15. Real estate owned by entirety (include one-half value)
16. Other real estate owned and located in North Carolina 4 0,000.0 0
t~ 11. Real estate located outside North Carolina 40, 000.00
~ TOTAL APPROXIMATE VALUE OF ALL PROPERTIES: 00
~ $83 X346 .
Sworn to and subscribed before me this
_1_~day of MARCH 19 80, •
! Signature of Applicant 'fit
i
r O. Box 475
Mailing Address
_ 3s - aat Clerk of S pert r ourt
{ u~tctn Smi t-h. .Tr_
i Attorney .
i
_su i t-r~ 1 1 ~ 27 ~N ~~a in St ~TLes-
ville N C Mailing Address ~r
i • •
Certified copy of this application mailed to the Department of Revenue, Inheritance Ta;
Division; Raleigh, North Carolina, as required by G.S. 105-22. (Su mit three copies to
the Department of Revenue.) ~
6
S
T1,is_~_aav oE_ ~~Cj~ 19 80 •
tant Clerk of S pert r Court
c.s, 105-22, G,S. 23-i, -6, -8, ~29 .
:HOC-L Fora 2 , ~ ~ 5 County
Rev 10/69
Do not use this s ice
i P• _ 8~r~~ Do not use this s aGe
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