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FO~ ~-~2 ~86~SS
STATE OF FLORIDA ~
DEPARTMENT OF REVENUE f
` ESTATE TAX BUREAU '
- TALLAHASSEE. FLORIDA 32304 ~
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J E~STRAUGNN NON-TAXABLE CERTIFICATE AND RECEIPT ~
UECU~~~E WR[CiOR FOR ESTATE TAX ~
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TO: Ina M. Paisley, Spouse D 13 7 4 0
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c/o Peninsular Title Ineurance Co. ~
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P.O. Box 3719 t
Fort Pierce, FL 33450 Re• Tl~e Fs[ace ot ~
• John J. Paisley
Deceaseil.
Orange
Resident of
Florida '
Counly,
June 28, 1974
Date : -
' - ~ 5.110 Fee Hecei~•e~l: -
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~ THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, ther~ 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 abov~ estate
is not subject to the Florida Est~te Tax. The issuaEice of this certificate, however, shall
not preclude the assessment and collec~ion of Estate Taxea subsequently determined to be
d ue the State af Florida .
If proof of non liability by the abuve estate for the Florida Estate Tax is required ;
a
b~~ any person this Certificate may be exhibited as evidence of such non liability. ~
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Given in qusdruplicate under my hand and the seal of the State of Flcrida the =
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date first above written.
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~ . Execut~ve D'erector
- . • . • Department of Revenue
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Not valid w?ithout sea~ affiaed .
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