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TALLAHASSEE
FREO O. DICKINSON. JR. `~~04
COY/~OLL<It ~ .
NON-TAXABLE CERTIFICATE AND RECEIPT C 17390
FOR ESTATE TAX
TO: . ' i '.:'t f° : ~ . ~t= , 5 c:~.z - Re: The Estate of .
-
_ _ 3.2~:i(`: ~ `t.ti'i.t~(i St tit':i?:_ _CiC; ~_'~'f:. i~ ' i.~.'. ;r;~Y>
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1~5 ~t . t~: . ?'1c~ V P S2Ll f? D~.
~~!.a~rl1 ~i17Z ~ Y ~_Ul I.C:r^ ~ ~,'f:
Resident of ` a ' ~ _
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Date: z~~-::. ~.f_,::
~1.00 Fee Reoeived: ~ ~ ~ ~
THIS IS TO CERTIFY, That in accordance with the provi.sions of Chapter 198, Florida
Statutes, there has been filed with this office a sworn report or return for Estate Taaes as
~ required by law and on the basis thereof it has been asoertained ttie above estate is not
! subject to the Florida Estate Tax. The issuanoe of this certificate, however, shall not pr~-
~ clude the assessment and oollection of Estate Taxes subsequendy determined to be due the
~ State of Florida.
~ If proof of non liability by the above estate for the Florida Estate Taa is required by
~ any person tvis Certificate may be e~ahibited as evidence of such non liability.
~ Given in quadruplicate under my hand and sesl the date first above written. "
x
~ . _ ~f FRED O. DICKINSON, JR.
~
~ _ - - ~ r••. ~y~~Jv .
; -
~ - ~ Comptroller of the State of Florida.
~ . -
~ ~ FiLEO AND ~ECORDE[!~ ~
~ ,
~ * S7. lUC1E COUNTY.' FIA.
~ - Rc.~'ORD VERIFtEO
~ ~~?~p3 -
~
~ Noc valid .~richout seal aff;aed. : 35 ~
~ '69 dUN 9 Z ~
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~ oc~~ t o~ Rc,s
~ ~ CLERK CIftCU17 COURT.~
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~ ~OOK~~ ~CE ~i 1f7
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