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STATE OF FLORIDA 2'73388
DEPARTM.ENT OF REVENUE
ESTATE TAX BUREAU
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~ TALLAHASSEE. FLORIDA 32304
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' ~ ED STRAUGMN NON • TAXABLE CERTIFICATE AND RECEIPT
~ ~ FOR ESTATE TAX
TO: ~is M. Van Cleve Spouse
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c/o Mr. Philip J. Harris, Atty.
P.O. Box 836
Warsaw, IN 46580 He: '['I~e F~ iatc oE Hiram H. Van Cleve
Deccased. F la . prop . in St . Luc ie Co
Re:i~lent of Koseiusko
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(;~,u~,t?~, Indiana ~
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Januarv 9, 1974
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TNIS IS TO CEBTIFY, 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
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 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 seaf of the State of Florida the
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date first above written . 2?73~8 3
F~~EO a~c aECOSOeo ~
ST. LUCfE COUNTY FLA. • ~
ROCEf+ .'41TRAS ~•/r/` ~9
- CLERK CI~~CUIT COURT ~
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Not valid without seal affixed .
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