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' Form E.T. C-614
N~N-TAXABLE CERTiFiCA?TE ~?Y E. GREEN, ~omptrouer
~°~'E So~, AND RECEIP7
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i STATE (~F Fl.ORIDA A J~.2 J~
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v'A,9~ TAl.LAHAS9EE
OF~~
Re: Estate of:
To ~ati.a~_~,,._~o~in..sc~n /~amie o vn
c~ a ~zn .tn . uc.te vu
o ~'IUmc.ru.~ a..~.z n
~~'m'~~/Ve.~ U~~, co~ty
~Q~oneli
THIS IS TQ CERTIFY, That s sworn return for Inheritance and Estate Tax has been filed by the duly qualified
representative of the above named Estate; an~ that, after allowing all lawful debts and other deductions and
the statutor~ exemption applicabl+e thereto, it was ascertained that said Estate was not ~ubject to Tax. The
issuance of .this. Certificate, however, shall not preciude the assessment and collection of taxes subsequently
determined to be ~due the State of r loric3a.
.As provided under Section 26, Chapter 14739, Acts oi 1931, and Section 15, Chapter 16015, Acts of 1933, this certificate
shall be authority for the County Judge wherein said Estate was administered to permit a final settlement or accounting
by the aforesaid representative thereof.
Given in quadruplicate under my hand and seal this, the day of , A. D. 19~.
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C`vmptrollpr's fee of $LQU ~ ~
Receiv - - ~ C<' ~i Z_ . C C , _ _
- ' ate ComDtrollpr, 5tate o! ~lorida
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FI A ~~g~CK
!,~`5~~~,1'~"- A'TL11 i DA•i 11~TU11 M TN
f~D~~~~ STEPHEN A. MOSER~ ESQ.
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