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' iORM DR-~2 ~ '
, STATE OF FLORIDA
~ DEPARTMENT OF REVENUE
ESTATE TAX BUREAU
I TALLAHASSEE, FLORIDA 32304
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EDSTRAUGNN NON-TAXABLE CERTIFICATE AND RECEIPT -
EaECUT~VE WAECTOR FpR ESTATE TAX
To: ~ - , - ~ ~ ~ - . . D 15 5 5
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Re: The Fstate of , : -
Deceased.
Resident of
County, -
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~ Date: ~ 1974
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f ~ 5.U0 Fce Necei~•ed.
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~ THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198,
Ftorida Statutes, there has been filed with this o~ce a sworn report or return for Estate r
~ Taxes as required by law and on the basis thereof it has been ascertained the above estate ~
~ is not subject to the Florida Estate Tax . The iasuance of thia certificate, however, shall '
~ not preclude the assessment and collection of Eatate Taxes subsequently determined to be
~ ciue the State of Ftorida.
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If proof of non liability by the above estate for the Florida Estate Tax is required ;
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by any person this Cer~ifrcate 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 above written.
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~ ~ ~ Executive Director
~ - Department of Revenue ~
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Not valid without seal affixed . =
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