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STATE OF FLORIDA E1~E~ ~~-'~+~E
S~ iU:! .;~IiTY FC~. ~ .
~ DEPARTMENT OF REVENUE F::~_~ ~F,~S -
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° ESTATE TAX BUREAU ; ;
~ ~ w TALLAHASSEE, FLORIDA 32304 --T~-- r
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` MA~ ~ '?~I
~ ~ 2'76237
J EO STRAUGMN NON - TAXABLE CERTIFICATE AND RECEIPT
FtECUTryE D~REC~dI
FOR EST~4TE TAX .
TO: _.,.r~~ ~
. . ~ , _ , ~ . _ , A 17 5 5 5 PP
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Re : The Estate of ; ~ _ ~ . . . . - - =
• Deceased . ~ - , _ . . , . , _ : , _
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j ~91dellt Of _ ~ Z %~~.r y
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~ County, - - _
~ Date : l , -
i $1. 00 Fee Received : _Aug`us t - , ~ ~
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~ THIS IS TO CERTIFY, .That in accordance with the provisions of Chapter 198,
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E F'lorida 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 i~ has been ascertained_ the above estate
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' is not ~ubject to the Florida Estate Tax. The issuance of this certi~cate, however, shall
; not preclude the assessment and coilection of Estate Taxes subsequently determined to be
; due the State of Florida. _
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; If proof of non tiability 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.
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~ Given in quadruplicate under my hand and the seal of the State of Florida the
date first above written.
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~ ~ . . - G~'~ J ~
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; = '3 _t . . ;
~ - ~ . • F,xecutive Director
~ ~ = a`: Department of Revenue
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Not valid without seal affixed .
? 224 PAGE~8~3
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