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r^~"' j~'. c"'+" '=M RECBIPT F(lR INHERITANCC AND TA'I'~ TAX RAY & GREb'~N, C;omptrotJsr
as l~uNUSiarioner nf Re~ra~~r ~
~TA'CE ~nF FLO~IDA "
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~,~~a c;f~MMiti~TOI~R C~F R~'v~~vir~: ,~a, 1426g E. T.
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•r~~ ~`4. TALt.ARA9.RLL~
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f Re: Fntate of: . - 'i
To . $~muel _Telis et ~1 ~ dqCOB TELTS, Deceg4ed__ _ _ 3
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Loa Angele.s, Ca1iiQ~'1~ta_ ~ Adeaipistered ;n ~larid~, Uade County i ~
Executors I Date o! Drseh: FebruarX,_26 1~60 Y i r
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I, ItAY E. (;KF,~N, C~:uptmller of the 34te oi Florida, •q Comm;seinn~c ~rf Revenue, do henby cxrtity that I am '
the otiicer of sai~ State ~svin custodp and eontrol M tha rocorda pertainin~ to the ssaearraeat aud eo]lection oi inheritanc~ ,
end ertaee tax payabie to it; t~at thet+e hsa bier~ filyd w3tb mo R sworn nturn ior estate tsx in the tnatter ot sbo~e nwmed
~ F.aetate end ~hsr the an,aunt of tsx •~e~+•eA Ap the SL~?te ot l"lorid~ agsimt saed E~tatP wara ~
EI GHT IIUNDRED AI~tD bh/ 100 $OO . bk !
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I t~inh»r certifp that the followinq Daq~n?ent~ }~ve been msde in tull ~pttiam~nt nf tha estate tsx saaoeRed R~raiaet said ;
E:~tAte:
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May ~0, 19b1 $800.6b Tax in Full ~
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IC i3 lurther certified Lhat nn refund of wc6 taz nor any portion thereaf hee ~~een sutharfzed and tbst no e4im ior J
rpf ~ind thereoY is ptstding. 2 d J a n u~ r y ~ 2
F.XE(:~tTF.i1 in quadruplicat~ und~t m,y h~?n+i anri sesl this the day e{ , A. D. 19._ . ~
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t ~.F:A[.) ~ r~~tnptrniler ot the Stat+e of Flt~ri~la, i
~ n~ ("rrmmussionc!r nt Revenue : ~
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