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STATE OF FLORIDA Q~3
DEPARTMENT OF REVENUE
ESTATE TAX 6UREAU
TAl.LAHA~SEE. FLORIDA 32304
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J. EO STRAUGHN NQN _ TAX~?BLE CERTIFICATE AND RECEIPT
EsEt~lT~vE MR[CT011 FpR ESTATE TAX .
TO: Jeffrey A. Malak $xeC. D 16164
c/o Jacobs, Buiekam and Malak, Attys.
16231 Wnsau
South Holland, IL 60473 Re• Tl~e Fs~ate of p~na A. gqgEbrecht
Deceased.
Resident of COOk
County, Illin ois
i Date: Auctust 7, 1974
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$S.UO Fee Received.
THIS IS TO CEBTIFY, Tha. in accordance with the provision$ of Chapter 198,
Fiorida Statutes, there has been filed with this office a sworn report or r~turr. for Estste
~ Taxes as required by la~v and on the basis thereof it has been ascertained the above estate
is not subject to the Florida Estate Taa . The iseuance of this certificate., however, shall
not preclude the assEasment and collection of Estate Taxes subsequently determined to be
due the State of Florida.
If proof of non liability by the above estate for the Flotida Estate Tax is required
~ by any person this Certifieate 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 aboye written.
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Not vslid without seal affixed .
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