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252483
FORM DR- 30t
, STATE OF .FLORIDA a,
DEPARTMENT OF REVENUE
° ~ ESTATE TAX BUREAU . ~
TALLAHASSEE, FLORIDA 32304
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J. EDSTRAUGHN NON-TAXABLE CERTIFICATE AND RECEIPT
EXEW7ryE OIREROR
FOR ESTATE TAX
~TO:~ertrude D. Sisk Sponse
c/o Mr. Paul Glasel C 9 3 4 2 5
• : ~Attorney at Law ~
~ -2620 Hollywood Blvd.
~ Hollywood, Florida 33020 ~ Re: The E~tate of Randolph E. Sisk
Deceased . ;
Resident of 8=0~~
~ County,_ Fl~rida
Date: Ag~~~ 4,.~~
$5.00 Fee Received ;
THIS IS TO CEftTIFY, 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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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, shali ~
not preclude the assessment and collection of Eatate Taxes subsequen~ly determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
i by any person this Certificate may be exhibited as evidence of such non tiability.
` Given in quadruplicate under my hand and the seal of the State of Florida the ~
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~ date first above written.
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