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~ STATE OF FLORIDA
DEPARTMENT OF REVENUE
ESTATE TAX BUREAU Return to:
Robert S. McCormick
` w ~ 7 C~~~L~.AHASSEE. FLORIDA 32304 p t O. gpx 1502
v Ft. Lauderdale, FL 33302
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J EO STRAUGMN NON -TAXABLE CERTIFICATE A'ND RECEIPT
EsECUTryE dA[LTOA FpR ESTATE TAX
~'O~ Adeline F. serte, spouse D 157 2 6
C/O English, McCaughan & O'Bryan, Attys.
P.O. Box 1502
Ft. Lauderdale, FL 33302 Re• Ti~e Es[ate of U~erto Berte
Deceased.
~
Broward
Resi~lent of -r-
Counl}, F loY'id a ~
- Date• July 31,1974
c:
` SS,IN) l~'ce Kecei~•ed.
THIS IS TO CEftTIFY, That in accordance with the provision~ of Chapter 198,
Fiorida Statutes, there has been filed wit6 this office a sworn report or return for Estate ~
Tax~s as required by law and on th~ basis thereof it has been ascertained the above estate
is not subject to the Florida Estate Tax . The issuance of this certificate, however, sha11
not preclude the assessment and collection of Estate Tsxea su~isequently determined to be
due the ~ta~e of Florida.
If proof of non liability by the above estate for the Ftorida Estate Tax is required
by any person this Ger#ificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida the
dt~te first abcve written.
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` ~ _ ~ 29(?396 Execut~ve Director
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~ , - ~ ~ Department of Revenue
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UMTY fU. W
' ~ - ~ AOCEit POITRA~ ~
" ' ~ CLERK CiRCWT CO ~
` .1~-. - . s,~~,- IIECORO YERIFIf
_ s.~ • ~ ~ORQf1~ (N THE ORlCL1l REfARDS S0~ D
• f]~! ~ 1 Gl
• ~ i Of 8R0~7ARD COIiNTY. FLOQI~A
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Not vslid w~ithout seal affiaed. . E. M. STROBEL ~
COUNTY Gt%MFtFGiLER ~
~oo~ 231 11:~3
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