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ST-21,455 ~ ~
~ORM DR- ~pt
STATE OF FLORIOA
OEPARTMENT OF REVENUE
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o~, ESTATE TAX BUREAU
~ _ a TALLAHASSEE, FLORIDA 32304
, . 0 2452so
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J. EO STRAUGHN NON -TAXABIE CERTIFICATE AND RECEIPT ~
E[ECUTivE OtREC7pR
FOR ESTATE TAX
TO:Everett E. Shellaberger Spouse
c/o Abstract & Title Corp . C 8 8 ~ 3 7
of Florida
P.O. Box 3696
Fort Pierce, Florida 33450 Re: The Estate of Minnie Leona Shellaberger
Deceased .
Resident of st T~uciP
COUIIty , Flc~ri da
, ~Rte' Der~PmhPr 29 ~ 1972
, _ _ _
~ $5 . 00 Fee Received : SamP
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
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~ Florida Statutes, there has been filed with this office a sworn report or return for Estate
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§ 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
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~ due the State of Florida.
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~ If proof of non liability by the above estate for the Florida Estate Ta~ is required
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~ by any person this Certificate may be exhibited as evidence of such non liability .
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~ Given in quadruplicate under my hand and the seal of the State of Florida the
~ date ~rst above written.
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~ - _~h~' ~ ~s~ j j'-:.~-;: . M.~A
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t : ry.- _ . :!-tiL
~4 ` Executive Director
- A~~~ ' ' Department of Revenue
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Not valid without seal affixed .
~ R O9 PAGE 24`SIsQ
a~K 2 2~~62
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