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COMMERCtAI UNION
ASSURANCE
OOMPANIES
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CWItT---a4~b
. .Apjli~n tor ~ond ~r~ ~n~n~stnbr. Euator.
Trusta.'B~MdKii, Conserv~ta. eh.
Conunerci a 1 l-ni on I nsurance Com~,anv _
Ol~ae ot Insursnte Comp~nr. herein~fter a11tA Comp~nrl
.~#}~~Ti ~ton i~ 1V~ lson Insurance A~~ency~ Tnc. CZ 711 34 82
P~ eo~a Kw~ee~
~ nere~- a~lce spp~icscion ro ue canp~ny tor eooo in cne ,mount o~ = 1, 000 . 00
,~ Guardian
~Jerner ~letz Inco eten ' E~. ~~'~. `w"~. ~'
of the est~te Ot ~ ~ .
Circuit St. Lucie Coun~y M0i""''""~°'~or'~~`p`~erce, Fla.
to De Ii1M ie Cowt or--
(Wpritl M C~wl~) (Cltl)~ (~ISbI
i. r~e ot s~K,n~ Hazel Hetz ~ N~
~aa~eu +~-~~oTi~a Circle, Port St. Lucie~ Fla. 33452
p~,~;o„ Housewife __ _ ~
Jl~plicsnrs net wwth _ Annw1 incane
t. wme a~e sae-ess or srtorne~r ~uY R. Bruni, Esq .. 8410 S. Federal IIwp. , Port St. Lucie _ Fla.
s. ~e ~ a~r-~r o-ne~ vN~ a~~r g~~~ eo~e ~~ M~s a~ne a n~a s~ ~ eaa d~ci~~a~No 33452
~f so. ~ive b~~ pu~iai~sr: '
~- Are you indeAted to the estate? ~~ 1~ so, Aow~ _
Is d~e tstafe indMtcd io you~ ~~ II Aow? - -
5. Do rou intend to opelste siryt busineu ptlon~in` to tAe eshte? t~~ 11 so, slste n~fure of such bus~ness. _____ _ ~ _
6. Wh~t is Your relationshro to the decas~d, m~n~r or~mpe lent.'--- Wife-- ---
~. oste ot ~r s~a~tn~,t ~Determined ~r C~ ~pq~t how {on~ wdl Mis Dond be in torte~ ~engt~ o~c~uar~ansFip
8. wiB pint tontrol Dt exerctsed._ _ so, ~rve nan~e ot dcpository _ _ _ __
md ~ttach bint Control A~-eement. -
9. 'IIST OF ASSETS ANO l1ABIlIT1ES Of ESTATE TO BE AOMINISTEREO
ASSETS I IWIlIT1ES
Home in St. Lucie County o~ned ~~int~y with wife -$58,000.00 1" I
~sank accounts in St. Lucie~Count~ ow#ied iointlv with wife - 5701_OOO.Ob
Automobile -$3,500.00 I I I I !~
- I I 4 I
~o. ~ ~iNatuia. ~cmoR wt m~s~:
t
W Cire d~te of decessed's dath
Ibl Nf~s xilt lound~ If so, ~llxA wp~r.
k! 6ire n~ncs. ~~es and rel~tionsAp oi heus sM beneficixies:
M~wt ~ A{e ~ ~elatansl~ lo O~cedt~t ~ AAAqst
I ~ --
~ ~
~ ' ~
( ~ f
~~~ ~~~~' ~~~i~ ~~~~~ 435 tJE Solida Cr. , Port St. Lucie,Fla.
~ cne a~~ o~ w~a~s a~ 2/ 9/ 13 wxa•: saa«u
m~ c~ ~e, sdduss snd relatior-ship of wuA's next of kin Wi f e as 1 i~ t e d above 3 345 L
12. Gire ptlow tAe ns~nes, ocwpslions sn0 sdMesscs ot three ~sons w firnis (not rel~t~res~ of Qood sts~dm~, ss refcrences.
w.. ' occwatiw ~ ~oar~u
~ ~
~ ~ ~
~~~, ~;K 348 F~~~ 7~'9
cao~oa s~!1K
4 9-59
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