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FORM OR- 702 ~~~jsSs
STATE OF FLORIDA
DEPARTMENT OF REVENUE
° ESTATE TAX BUREAU -
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TALLAHASSEE. FLORIDA 32304 ~ „ ,
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J. EOSTRAUGMN NON-TAXAB~E CERTIFICATE AND RECEIPT
E7tECVTNE OIAECTOR
FOR ESTATE TAX '
TO: ''=xs . Rc~se : . L~s::oe ~
3405 Cuts~^a•,~ Avenue ~
Ric'_i::~ond, ~~irginia 23~30 C 93261 ~
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Re: The Estate of ~at~~n ~~s!:c:~
K~ ANORE D Deceased. rz,;, r~r~~. zn ~:t. U~.~cie~
- ~fiX~c~ cqu~~~~~A,
ROCC +~CUItR~ ~~ident Of
~r i~t;se ~LERK i pOyRT ~
RE oRO v~a~~~~o ~
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g3 P~ ~RR~~ Virrcinia :
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~8te : ~A~ ~ ~ Z r~ ~ i 3
, ~ ~5 . 00 Fee Received : s.-~..m~ ~
i THIS IS TO CEftTIFY, That ~n accordance with the provisiona of Chapter 1~8, ~
~ Florida Statutes, there has been filed with this office a sworn report or return for Estate ~
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Taxes as required by Iaw and on the basis thereof it has been ascertained the above estate i
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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 proof of non liability by the above estate for the Florida Estate Tax is required s
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by any person this Certificgte 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 first above written.
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~ F; n t.S j,~ r. ~ I
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~ - ~ , . . Executive Director ;
~ ' ~ ' , ~ r" Department of Revenue ;
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Not valid without seal affixed . ~
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