HomeMy WebLinkAbout1158 3U 5~3
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;lndude atnuuot set off or allowed under Sections 2115.13 and '2117.20. Revise-d Caie,j `l
;ticc Se•rtiun 531.15, Nevised Code.j
lame and Address of Brne6ciary ~ Age Relaticurlhip .lmount
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CALVIN !`l. h;~ i CNIt~IS ;
PR03A1"r !ll~~~
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tiC1fEDUi.E ~1 - RECaPITULATiO\
St-heduM Croce Estate Total ~`alue on
I7atr• of Ikath
A Real Prolxrrh~ - - - - - _ $
B Stocks and Bonds _ _ 4 S 7.(123 4 4
C ~fortgages, \otes and Cash . . . _ 773.19-. 47
D insurance . - - _ _ _ . _ _ _ _ - .
E Joint and Survivorship Property . _ _ ~~9~257,92-
F Other Miscellaneous Property . _ 300.00
G Transfers During Life Time _ _
N Powers of Appointment - - - - -
I Annuities. Pension, Retirement Plan - _ .
Totai Cross Estate - 5-21-1x30-0~83-
Ueclaration
(Section 5731.22, Revised Code, provides a maxinwm penalty of =1,000 for failure to file a tetum. If failure to file or any
underpayment is due to fraud a maximum penalty of 510,000 is provided.)
I declare that this return including accompanying statement(s) has been examined by me and is to the best
of my knowledge and belief, a true, correct and complete return made in good faith. •
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__6-24-74~~.i.%~~~cL~~ t~t~ .~i 1031 Prospect Avenl~e
ate Sisr,atureorFidaciary~~~- Ashtabula, M~i.~o 44004
Other Person Film` Return
Declaration of Attorney or
Other Person Filing Return
I declare that I have prepared this return for the person(s) whose signature(s) appears above, including
any accompanying schedules and statements, and that it is, to the best of my knowledge and belief, a true, cor-
rect anal complete return based on all information of which I have any knowledge.
_6-24-74 - .f l~-t~C~/J~Lu~-~~.Q4:.•~` _p.p, Box 267 Ashtabula,
Oate Sitnaturs of Preparer Other Than AddmQh ~ 0 4 4 0 0 4
Fiduciary, rx Othn t7eclarant Filing Return '
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