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iORM OR- ~OZ
. STATE OF FLORIDA
DEPARTMENT OF REVENUE ~
ESTATE TAX BUREAU `
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1 EO STRAUGHN NON -TAXABLE CERTIFICATE AND RECEIPT =
FQR ESTATE TAX
TO: Blanche Liebelt Spouse
c% Bryan and Koblegard, Attys. A 19 7 0 9 PP ~
P.O. Box 3230
Ft. Pierce, FL 33450
fte: The Estate of George Dewey Liebelt
Fla. prop. in St. Lucie
Deceased . county
Resident of ---gueens ~
County, New York ~
Dste : June 13 . 1974
$5.00~~-0A Fee Received: January 4, 1974
THIS IS TO CERTIFY, That in accordance with the provisiona of Chapter 198,
Florida Statutes, there has been filed with this office a aworn report or return for Estate
Taxes as required. by law and on the basis thereof it has been ascertained the above eatate
is not subject to the Florida Estate Tax. The iasuance of thia certificate, however, shall
not preclude the assessment and.collection of Estate Taxea subsequently determined to be ~
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due the State of Florida.
If proof of non liabitity by the above estate for the Florida Estate Tax ia 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
E date ftrst above w?r~~ten.
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: . . Executive Director
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Not valid without seal affixed . ~
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