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FORM DR- 30I
STATE OF FLORIDA ~
DEPARTMENT OF REVENUE CfR PB~T C~~T
SL`_'~'a,~ ESTATE TAX BUREAU Rf~oan vcR~
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J. EDSTRAUGHN NON-TAXABLE CERTIFICATE AND RECEIPT
f~EC~iT~VE O~RECTOR
FOR ESTATE TAX
TO: Salvatore Costanza, Exec.
c% Mr . Robert M. lloyd C 8 3~~~
~ttorneyat Law
P.O. Box 1270 Re: The Estate of Rose Costanza
Fort Pierce, Florida 33450 Deceased.F]a. Prop. in St. Lucie Co.
Resident of Bergen
County, New Jersev
Date• September 20, 1972
~ $5. 04 Fee R.eceived : same
THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198,
f~'lorida Statutes, there has been fited 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 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 tiability by the above estate for the Fiorida Estate Tax is required
b~ any person this Certificate may be exhibited as evidence of such non liabiiity .
(:iven in quadruplicate under my hand and the seal of the State of Florida the
date first above written.
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:V'ot valid without seal af~xed. ~~jX210 ~'I1GE1252
RECEIVE~ S~Q 2 1 1972
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