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NON-TAX..OBLE CERTIFICATE AND RECEIPT
FOR ESTATE TAX ~ .12143
1'Q; Gracieuse LeBel, Exec. Re: The Estate of Cyriac L. Dery
c% Mr. Fred M. Conway ~7~~~
Attorney at Law I~~eased.
P.O. Box 1855 . ~
Ormond Beach, Florida Resident of ~ vo~.usia - •
County, - Florida
j,~tQ; ~ March 18. 1969
~1.00 Fee Reoeived: same ~ "
THIS IS TO CERTIFY, That in acoordance with the provisions of Chapter 198, Florida
Statutes, there has been filed with this office a sworn report or retum for Estate Taxes as
required by law and on the basis thereof it has been aso~rtained the abo~ve estate is not ~
subject to the "Florida Estate Taa. Th~ issuance of this certificate, howe~ver, sball not pre-
clude the assess~ment and collection of Estate Taxes subsequendy detenmined to be due the ~
State of Florida. - .
If proof of non liab~ity by the abuve estate for the Florida Estate Tax is required by
any person this. Certificate may be e~zhibited as evidence of such non liability.
Given in quadruplicate under my band and seal the date first above written. -
I~ ~ ~ ~ ~ FRED O. DICKINSON, JR. ,
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~ : ~ ` ~ : Comptroller o the State o Florida.
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