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;tbYF,R, I,EBEN, F1XE1. and GAINES CIEf?K Ci~?UIT CouRT •
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STATE OF FLORIDA
DEPARTMENT OF REVENUE
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~ o~ ESTATE TAX BUREAU
" ~ ~ TALLAHASSEE, FLORIDA 32304
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EO STRAUGMN NON - TAXABLE CERTIFICATE AND RECEIPT
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ExECUTivE D~REC7pR FOR ESTATE TAX
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'I'Q• Anna Ruth Myer Admin. ~
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c/o Pollak, Siegel & Zoller A 1_ Q r b~~1'~P
Certified Public Accountants • ~
2435 Hollywood Blvd. -
Hollywood, Florida 33020 Re: The Estate of Laverne E. Mye~
Deceased .
~ .
` ftesident of Broward
County, Florida
~ Date: December 8, 1972 9
$5.00 $~}-e(~Fee Received: June 28, 1972
~ THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
` Florida Statutes, there has been filed with this office a sworn rQport oc rPturn 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 ~
~ due the State of Florida. ;
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` If proo: of non liability by the above estate for the Florida Estate Tax is required
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~ b~• any person this Certificate may be exhibited as evidence of such non liability. ~
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~ (~iven in quadruplicate under my hand ar~d the seal of the State of Florida the
~ date first above written. - =
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- Executive Director G~
- ~ " Department of ftevenue
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Y Not valid without seal affixed . ~~oco~r o~~
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