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STATE OF FLORIDA sT' ROCc P4ITRA8
. DEPARTMENT OF REVENUE CLERK CIRCUIT GOURt
' ESTATE TAX BUREAU RECORO vERiFtEO~ :
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T~?LLAHASSEE. FLORIDA 32304 20 '0 33 ~11 i?~ j
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Eo s*R~~MN NON -TAXABLE CERTIFICATE AND RECEIPT -
E~ECU~~1~t ON~~CTOR . ~OR ESTATE TAX
TO: I~sar jorie Lewis spouse ~ ~ 5 8 3$, ~
c/o Mr. Edward R, Rumin, Atty. z
P.O. Box 11025 . ~
Fort Lauderdale, FL 33306 Re• The Escats of -
• Paul A. Lewis c..= -
~ ` l i Deceased. ~'O
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~~'r;~~~ , Resident of Broward N
Aifv~`~~=Y k~ L~W Florida ~
2870 E. G~+~,~~,~:t7 F~?RK BLYD. ~ County,
fORT 1.Ai;DEitui'3~t, ~LA. 33305 Date• March 27, 1974
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i $5.00 Fee Received.
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~ THIS IS TO CESTIFY, That in'accordance with the provisions of Chapter 198,
~ Florida Statutes, there has been filed with thia office a sworn report or return for Estate .
Taxea as required by law and on the basis thereof it haa been ascertained the above estate
is not subject to the Florida Estate Tax . The issuance of this certificate, however, ahall ;
not preclude the assessment 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 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 ~r~t above written.
~ . ; _ ' _ ~j~~ ~ D~~ d
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_ ~ ~ , , ~ Eaecut~ve Director p
~ ~ Department of Revenue ~
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•.r ~ ~OED IN tHE O~1CiAl RfCOROS 60~
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~r ~ • Of BeZO;MARO CQU(/i~. FlDitIDA
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- t~: E. M. STROB~L
. - oowmr corvtAOtt~ C'J
Not valid w?ithout seal affixed , ~J
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