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RICORD YE~tF1Eo..~.....•~•• 546 S.~. 3r~i aVE. .
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STATE OF FLORIDA '
" DEPARTMENT OF REVENUE
~ ESTATE TAX BUREAU
~ TALLAHASSEE, FLORIDA 32304
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Eo STRAUGHN NON-TAXABLE CERTIFICATE AND REC~IPT
`~""T'"` FOR ESTATE TAX
Z'4~ Hazel T. Jellings, Spouse
c/o Mr. William G. Miller, Jr. C~' 161
Attorney at Law
546 S.E. Third Avenue Re: The Estate of John Leslie Jellings
Fort Lauderdale, Florida 33302
Deceased.
Resident of Broward
County, F lor ida
Date: - February 2 , 1972
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$ 5 .OOareU Fee Received: same
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; THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198, F~rida r"^.,
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Statute~. tl~ere has been filed with thi• office a sworn report or return for Estate Ta~ as
requirecl by law and on the basis thereof it ha~ been ascertained the above estate i~° not
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; subject to the Florida Fstate Ta~. The issuance of this certificate, hoK•ever, sLal! not~re- ~
~ clude tlie asae~sn~ent and collection of Estate Taxes subsequently detern~ined to be du ~ he
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State oi~ Florida. ~ o
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= il' proof of non liability by the aliove estate for the Florida Estate Taa is requirec~°by
~ any per~on thi~ CE:riificate may be ethibited as evidence of such non liability.
~ Given in quadruplicate under my hand and the seal of the State of Florida the date first ~
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~ above writt~,i,
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