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~,~,ES>.~ HNAL CERTIFICATE
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v 4 FOR INHERITANCE AND ESTATE TAX
` _ ~ STATE OF FLORIDA
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TALLAHASSEE N~~1 1 H Ej ~ E.T.
To Re. The Estate of Geo~ge U. Shelby, Sr.
George U. Shelby, Jr. ~~d.
Executor Resident of Mississippi~
Charleston, Missouri ~~ty~ . Missouri -
Date: November 6, 1974
Date of death: 9-18-70
THIS IS TO CERTIFY, Tliat in accordance with the provisions of Chapter 198, Florida
Statutes, there lias been filed with t6is office a sworn return for Estate 'raxes as required by law
in ihe above named Estate and diat the amount of tax assessed by the State of Florida against aaid
estate was SEVEN HUNDRED TWENTY AND 59/100
i
' - Dollars 720.59 1.
i It is futther certified that the following paymenta have beea made in full settlement of the
~ estate tax assessed against said estate:
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~ November 29, 1972 $587.78 Tax
~ January 17, 1973 $32.32 Interest $ -
October 29, 1974 $22.82 Interest $132.81 Tax ,
55.14 Interest 720.59 Tax in Full ~
LEO ANG E LO =
~ ~uct Rc~`ur~~ir~u. ~
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CLE~K~CIFCU T C U1tT
~ RECOR~ VEA~r~ED
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" and that no refund of sucli taa nor any portion tliereof has been authorized and that no claim
~ for refund thereof is pending. ~
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~ ~~`.~'~~y"et~ _~~adruplicate under my liand and seal of the State of Florida the date f irst above
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~ '~~;,r ~ ' ; . ` Executive Director
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;;9~ ~T~. `r Department of Revenue
':;`i.~~~`-f"~;jii~itl~oui a~al affixed. d00Y~r1~1~ PACE~~
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