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FORM OR-~02
STATE OF FLORIDA
DEPARTMENT OF REVENUE
ESTATE TAX 6UREAU
TALLAHASSEE. FLORIDA 32304 qp,~~~
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~ Eo 5,~~~HN NON -TAXAgLE CERTIFICATE AND RECEIPT
FOR ESTATE TAX
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TO: Estel~e colc~ery Execx. 07 3 2~
c/o Mr. ~lmanuel Sponder, Atty.
6006 Miramar ParkwaY
Miramar, FL 33023 Re: The Estate of
Samuel Adin
Deceased.
Resident of Dade
Cuunty, Florids
Dacc- April 22, 1974
SS.fHI ~ ee Received.
` THIS IS TO CEKTIFY, That in accordance with the proviaione of Chapter 198,
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9 Florida Statutes, there has been filed with thia office a aworn report or return for Estate
Taxes as required by law and on the basis thereof it has been aacertained the above estate
is not subject to the Florida Estate Tax . The isauan~e of this certificate, however, shatl
not preclude the assesament and collection 4f Estate Taaes subaequently 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 seal of the State of Florida the .
date first above written.
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- • Department of Revenue
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Not vstid;~3t~iont eeal affixed. .
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aooK227 Pac~ 672 2~81600
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