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FORM OR- 302 1
STATE OF FLORIDA
DEPARTMENT OF REVENUE
° T~ ESTATE TAX BUREAU
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~ o TALLAHASSEE, FLORIDA 32304 23~3~9
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J. EOSTRAUGHN NON•TAXABLE CERTIFICATE AND RECEIPT
EaECUTIVE DIRECTQR
FOR ESTATE~ TAX
TO:Leona Roth, Spouse
c% Mr. RuQert Jasen Smith y 8 19
Attorney at Law
209 Raulerson Bldg . Re : The Estate of Joseph Roth
Fort Pierce, Florida 33450
Deceased .
Resident of st. Lucie
County, Florida
Bg~~• Atxgust 29, 1972
$5 . 00 Fee fteceived : same
Ij THIS IS TO CEBTIFY, 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
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E Taxes as required by law and on the basis thereof it has been ascertained the above estate
is not subject to the Florida Estate Tax. The issuance of this certificate, however, shall
not preclude the assessment and collection of Estate Taxes subsequently ~determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
by any person this Certificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seal of t; e State of Florida the '
date first above written.
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~ t, Executive Director
~ Department of Revenue F~~EO ANO RECOROED
. - ST. LUCIE COUMTY FLA. ~1 ~
- ROCE~t POITRAS `
- CLEtiK Ci?~CUIT COURT '
RECORp yF;,,FiED_„~~
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~ S~' S 10 si AH '12
Not valid without seal affixed . Z3'~3~9 j
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