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FORM OR-I02 x
_ STATE OF FLORIDA ~Y~ ~ G ~
DEPARTMENT OF REVENUE ~ER R
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~'o~ ESTATE TAX BUREAU sE~ORf~ ~E~~~F1L~ v~{ ~ ~
~ ~ TALLAHASSEE. FI.ORIDA 32304
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' 224955
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NON-TAXABLE CERTIFICATE AND RECEiPT '
E7tECUTtVE O~RECTOR
FOR ESTATE TAX .
TO: ~irs fistella J. S~rbacher, Spouse *
2?44J Glen Brae Dr. ~
S~ratoga, Ca lifornia 95~7C~ A 0 512 7 PP
Re : The Estate of ~
Joseph Leor. Sarr~ac-het
Decessed . F i a , pr . ~ ~ . ~ i - -
Resident of ~ t ~:~n
COU4t Grc~r9 ia ~
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. Date• P'ebruary ? l_, i9?2
S 5. o o ;~.,$Q Fee fteceived : - , ~
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THIS IS TO CEftTIFY, That in accordance with the~ provisions of Chapter 198, '
~ Florida Statutes, there has been filed with this office a sworn report or return for Estate ~
> Taxes as required by law and on the fiasis thereof it has been ascertained the above estate ;
~ is not subject to the Florida Estate Tax . The issuance of this certificate, however, shall ~
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not preclude the assessment and coltection of Estate Taxes aubsequently determined to be ~
f
; due the State of Florida. ~
~ If proof of non liability by the above estate for the Florida Estate Tax is required ~
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~ by any peraon this Certificate may be exhibited a~evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida the ~
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- date first above written . ~
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_ ~ - ~ Executive Director
- _ ; , i~~ : Department of Revenue
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_ Not valid without seal affixed. ~
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