HomeMy WebLinkAbout1153 GROSS ESTATE SUBJECT TO TAY
Answer all questions "yes" or "no' and insert de~rriptiuu in tlu• space pruvidctil or add additional
pages. !f any property or interest claimed not subject to tax attach a supporting statement. At-
tach copies of will, treat instrument and other relevant data.
SCHEDULE A -REAL PROPERTY
Uid decedent have any interest in real property located widrin Ohio? _ _ _ no
(Cornish location, street address, irnprovanerts, whether n•siclcutial, comn,crrial, or fans land together with
ge~ncral description.) (Place joint and survivorship real property under Sctredulc E.)
SCIEDULE B -STOCK AND BONDS
Did decedent have any interest in stocks or bonds regardless of dreir location? _ _ _yes
(['unrish number of shares, whether common or preferred, par value, where sold it other than New York Ex-
ch:urge, such as A.S.E.,'41.W., O.C., etc. and u:rit price; per sh:ue. Include any accrued dividends due as sep-
;rrate item. For inactive stocks which arc closely held, furnish additional supiwrting Gnancia) data from the
curlwration. For bonds, include total face amount, obligor, kind and rate of interest, date of maturity, interest
~luc• dates plus acY•nrcxl iuterest to date of death. Include all lxrnds, local, state :md U. S. Cuve•nuuc•nt iuc•hrd-
iug those p:ry:rble uu death. (Place joint and survivorship pp~~'`~ rdcr 5ched ~ E. ~
SCHEDULE C - 11iORTCACES, KOTES AND CASH Y ~7 _ r~+s ~ ~
Uid decedent have any interest in mortgages, promissory g~tes= ntracts, ur? rte ca o~deposits
in any 6rrancial instihrtion regardless of location? . ~'~s
(For mortgages furnish face value and uni~aicl balance, execution date and mahrrity date, name of maker and
property mortgaged and interest elates and rates. Furnish similar information for promissory notes. For land
contracts furnish name of vendee, execution date, sale price and unpaid balance, interest rate and descrip-
tion of property. State Location of cash. For deposits, i;ive name of bank, number of deposit and balance on
date of death including accrued irterest. Include all types of deposits in which decedent held an interest
giving the name of the bank, deposit number, and thc• h;dance on the date f ca u h ding accnred inter-
est, Include P.O.D. and trwtee deposits in this schedule.) (Place joint a~d s~rv~vor ttip~perty under Sched-
u2e E.)
SCHEDULE D-INSURANCE ~ $ to?.'
Uid deoeclent have any interest in a life insurance policy or other insurance contract a able to the estate?
(Include general description of policy or contract.) ~.-4i~.4'~~'1lS__ no
SCHEDULE E -JOIN? AND SURVIVORSHIP PROPERTY PRC~3A? !l~~E
Did decedent have any joint and sruvivorship property registered in his name? _ _ yes
(Include aU types of property which would otherwise ire described in Schedules A, B, C, D and F except real
property located outside Ohio regardless of location including name of survivors and relationships. Include
stocks, deposits, investment accounts and bonds including those of the U. S. Government.) (See Section
5731.10, Revised Code.)
SCHEDULE F -OTHER 11iISCELLANEOUS PROPERTY
Did decedent have any other interest in property not listed under any other Schedule? _ yes _
(Include partnership interest, sale proprietorship or other business interests with supporting information for
valuation including goodwill. Include debts due decedent, rights, royalties, reversionary or remainder inter-
ests, tau ref?urds, judgments, household goods and personal ellects, automobiles, trailers, farm products and
machinery.)
SCHEDULE G -TRANSFERS DURI1*G LIFETIME
1. TRANSFERS IN CONTEMPLATION OF DEATH. Did decedent transfer any property or interest there-
in within three years of death without an adequate and full consideration in money's worth? no
(Include description, date of transfer, and transferee. If transfer is claimed to be mot in contemplation of
death, attach explanatory st.3tement.) (See Section 5731.05, Revised Code.)
2. TRANSFERS WITH RETAINED Eiil]OYtiiENT. Did decedent at any time transfer any pproper or in-
terest therein without an adequate an full consideration in money's worth in trust or otherwiste under
which he retained:
(a) the income or the right to possession and enjoyment until his death? no
(b) the right, either alone or in conjunction with any person, to designate the persons who shall enjoy the
property or the income therefrom? ~ no
(Include description, date of transfer, transferee and submit a copy of instrument of transfer.) (See Section
5732.06, Revised Code.)
3. TRANSFERS WITH REVERSIONARY INTEREST RETAINED. llid decedent at any time transfer any
property or interest therein without an adequate and full consideration iu money's worth in trust or other-
wise where: '
(a) possession or enjoyment can be obtained by other persons only by surviving the decedent, and
j) the decedent retained a reversionary interest by the express terms of the instrument which hacl a value
as of the date of death in excess of 5`"0 of the valve of the property transferred? no
(Include description, date of transfer, transferee and submit a copy of the instrument of transfer.) (See Section
5731.07, Revised Code.)
4. TRANSFERS SUBJECT TO CHANCE: Did decedent at any time transfer any property or interest there-
in without an adequate and full consiclcratio» in morre~'s worth in trust or otherwise where the cnjoyrnent
on the date of death was subject to any change through the exercise of a power by the decedent alone or in
conjunction wit2r any person to alter, amend, revoke or terminate? _ Ilo _
(Inclu~e description, date of transfer, transferee and subrnit a copy of the instrrment of transfer.) (See Section
5731.08, Revised Code.)
SCHEDULE H -POWERS OF APPOIyT!1lENT
Did decedent possess a general power of appointment over any property? no
(Furnish descripption and include any such property ~~•Ircre decedent has at any time exercised or released a
general power by a disposition which if it were a tran~fcr by the decedent, it would have otherwise been in-
cludable in this estate.) (See Section 5731.11, Revised Code.)
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