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FORM DR- )O2
STATE OF FLORIDA
' DEPARTMENT OF REVENUE
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° ESTATE TAX BUREAU 24s222
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~ o TALLAHASSEE. FLORIDA 32304
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J. EOSTRAUGHN NON-TAXABLE CERTIFICATE AND RECEIPT
E%ECUTtvE O~RECt~R FOR ESTATE TAX
TO:Mabel Vandivier Spouse
c/o Mr. J. Richard Sendik C 8 7 5 5 6
Attcrney at Law
6324 West North Ave.
Wauwatosa, Wisconsin 53213 The Estate of Edward W. Vandivier
Deceased. Fla. Prop. in St. Lucie
Resident of _ ~~,~.~,,~u.~ao
County, wisconsin
Date • n~ :ombo~-ld~ 1A-72
$5 . 00 Fee Received : samQ
THIS IS TO CEBTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, there has been ~Ied with this office a sworn report or return for Estate
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 certi~cate, however, shall
not preclude ihe assessment and collection of Estate Taxes subsequently_ determined to be
due the State of Florida.
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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 the State of Florida the
date f rst above written .
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Not valid without seal affixed .
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