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STATE OF FLORIDA ~ '
DEPARTMENT OF REVENUE ~
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ESTATE TAX BUREAU
~ w TALLAHASSEE, FLORIDA 32304
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1 ED STRAUGNN NON -TAXABLE CERTIFICATE AND RECEIPT
EfECVTwE O~N[CTOw _
FOR ESTATE TAX
TO: Mary Alice Bailey Petitioner
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c% Moie J. L. Tendrich, Atty. ~
2240 Biscayne Blvd. _
Miami, FL 33137
Re: 7'he I-:.tate ot Loreine Fields
I)~~t•c~a~t•d.
' Ne~i~lt•nt uf St. . ~ i
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j C~~unt~', . Flprida
i),,~~~: January 17. 1974
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THtS IS TO CEBTIFY, That in accerdance with the provisions of Chapter 198,
; Florida Statutes, there has been filed with this office a sworn report or retetrn for Estate
~ Taxes as required by law and on the basis thereof it has been ascertained the above estate
` is not subject to the ~'lorida EstaLe Tax . The issuance of this certificate, however, shall '
; not preclude the assessment and coliection of Estate Taxes subsequently determined to be
due the State of Florida.
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; tf 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 first above written.
I~'`'`9
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; Executive Director ~
Department of Revenue
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~ Not valid without seal affixed .
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