NRS-13340-1-[20-2391]-Pre A 125294 Chow Sum - Flipbook - Page 3
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No.
sntrecilonlilMia611111111112311111.1.11,
WSW 4111 1 ,00;*"
Form of affidavit to bFlodge61 with application for administration.
NEW SOUTH WALES,
TO WIT.
In the estate of
late of
(3,„,,„ • Strike out whichever
is unnecessary.
CHOW SUM
VC.rth
Tara
....F.a_rm.er
in the State aforesaid,
deceased,
ON the
W40,
n
es a
e
day of
tbirty-eight„ MATTHEW HENRY LOWE,.
of Sydney_ ,. in the State of New South Wales, Deputy
Public Trustee.
one thousand nine hundred and
If more than one applicant, the form to be
filled up accordingly.
being duly sworn, maketh oath, and saith as follows :---
The fii4gif tisustee is
eIc e the party/gankx making application for the purpose of obtaining
administration of the estate of the abovenamed deceased and the party49dm liable for
the payment of the duty, if any, on the estate herein included.
t State whether married,
bachelor, spinster,
widower, widow,
divorcee, or minor.
* State whether
domiciled in or out of
New South Wales.
The abovenamed deceased who died on the
19
:14'7, aged_
was domiciled
28th
_years, was at the time of death t
Getob-er
Mar ri ed
and
day of
in New South Wales
The annexed inventory contains a true statement of all au3 singular the real and
personal estate of or to which the abovenamed deceased was possessed or entitled liable to
duty under the Stamp Duties Act, 1920-1933, and of the values thereof, and includes the whole
of the accruing income in the estate up to the date of death. The debts therein stated were
actually due and owing at the date of the death of the deceased, and are such as 'may be
deducted under section 107 of the Stamp Duties Act, 1920-.1933.
Words in full.
The final balance of the estate of the abovenamed deceased is
Nil
the Public Trutee
In the event of any additional assets being discovered, XXXOtviii advise the Corn-
1.1.11101111.1...101111100ffiglit.1.1114W
IIIIESIIIMIDIM.
vansmismaxernmarammint,
missioner of Stamp Duties, and will pay any further duty found to be payable.
V.1112111111111113IMMUNIONail
Strike out clause if not
applicable.
Regulation form to b
used.
The deceased having been domiciled in the State of New South Wales and the
amount of the dutiable estate wh aggregated with the value of the foreign assets after
deducting all debts due and owin, other than debts referred to in sub-section 2 of section
107 being under the sum of five ousand pounds I/we claim an assessment of the duty
payable at one half of the sched le rates set forth in the Fourth Schedule to the Stamp
Duties Act 1920-1933 on the prop ies set out in the annexed schedule marked " A " after
deducting the proportion of the •' _bts chargeable thereon as the said properties pass to the
*Widow and/or childrerA
lawful *
Strike out clause if nott/
applicable.
The deceased having been do iciled in the State of New South Wales and the
amount of the dutiable estate when ag, egated with the value of the foreign assets after
deducting all debts due and owing other than debts referred to in sub-section 2 of section
107 being under the sum of One thousan Founds I/we claim exemption from duty on the
properties set out in the annexed schedu marked " B " after deducting the proportion of
the debts chargeable thereon as the said pr perties pass to the lawful*
of the deceased.
Qi1Prel.T.Alation form to be
used.
*Widow and/or
children.
Regulation form to be i
used.
Strike out clause if no
applicable.
of the deceased.
8. The annexed Schedule marked C " contains a true statement of all and singular
the real and personal estate and the val es thereof of or to which the abovenamed deceased
was possessed or entitled outside the Sta e of New South Wales at the time of death other
than real and personal estate liable to du un der the Stamp Duties Act 1920-1933.
Strike out clause if not
applicable.
9. The deceased was not possessed of or entitled to any property in New South
Wales or elsewhere at the date of his death other than the property set out in the annexed
inventory.
Sworn by the deponent on the
day first abovementioned at
Sydney
DEPUTY. PU.EiLIC TRUSTEE.
before me,—
A Commissioner for
(or) Justice of the eace.
St. 9341
M 785
