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' F«m oR-3o6 STATE OF FLORIDA
Rev. J~n. 1, 197~
DEPARTMENT OF REVENUE
dTHE3Tj~4 ESTATE TAX BUREAU
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NON-TAXABLE CERTIFICATE AND RECEIPT ~
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Eo sM~~aHN FOR ESTATE TAX
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No. A17945PP ~
TO: ~
Dorothy Brubach, Spouse
c/o Mr. L. A. O'.Laughlin, Atty.
P.O. Box 3405 ' .
Ft. Pierce, FL -
Re. The Estate of Norman L. -Brubach ~
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a~(t~ Deceased.
f ~~UC1E COUN
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i~ aOOER r~,Ta ~T c. Resident of ~t _ r.»~; P
a~EaK ~~f f IEO COiI
OR'~ YE~ ~
Pfc ~ conncy, - F, ~~;_r7a-
d 21 11 qz
F~ Date: Ma rr~h 6~, 19 74
a~il~ = 5.00 Fee ReceiYed : FP~ry_;
g.~ 19 7 4 ;
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THIS IS TO CERTIFY, 1'hat in accordance with the provisions of Chapter 198, Florida ;
6ta~ctutes, there haa been filai with thie office a aworn report or return for Estate Taaes as ~
reqnired by law and on t6e basia thereof it has been ascertained the above estate ie not sub- ~
ject to the Florida Estate Tas. The issuance of t6is certificate, however, shalt nut preclnde the s
assessment and collection of Estate Taxes snbseqnendy determined to be dne the State of Florida.
If proof of non liability by the above estate for the Florida Estate Taa is required by any
peraon thie Certificate may be eahibited as evidence of snc6 non liability.
Givea in qnadrnplicate nnder my hand and seal of the State of Florida the date first above
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~ Not valid withont eeal affixed.
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~ I HEREBY CERTIFY tiiat the above is a trae and oorrect oopy as it appears from the re -
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# cords of this office.
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F~~SS WHEREOF, I ha~e hereunto set my hand and the seal of the State of Florida
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