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a STATE O~ FLORIDA
; ~ ~EPARTMENT OF REVENUE ~ j
~ , ° ESTATE TAX BUREAU #
TALLAHASSEE. FLORIDA 32304 ;
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~ ~5199 ;
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J. EO STRAUGMq NONTAXABLE CERTIFICATE AND RECEIPT
EIIECU~~IIE OM[CTOII ~ :
FOR ESTATE TAX ~
TO: ?~ar•v ~nr~~~ Si' ls , Petit .
D 31348 =
C!n Alley, :i~ass, R~~,ea~s, Linc~say
~.~d C::aun~e~~, Attys .
P, 0. Rox u 3 2 Re: Tl~e Estate of ~
~dir^ ~each, r~. 3~1i$t~ ,+esbit S1iZS' ~7`•
Deceased.
• - { ~ • Resident -of T ' ?-~~.+t~ n " • ~
County, r~a~,~~
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Date• l;arch 27.,_~ A~
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$5.00 Fee Received: -
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~ THIS IS TO CEItTIFY, That in accordanee with the provisions of Chapter 198,
f Florida Statutes, there has been filed with this office a aworn report or return for Estate
~ Taxes as required by law and on the basis thereof it hae been ascertained the above estate
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~ is not subject to the Florida Estate Tax . The issuance of this certificate, however, shall
€ not preclude the asseasment and collection of Eatate Taxes subsequently determined to be -
~ due the 3tate of Florida.
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a If proof of non liability by the above estate for the Florida ~state Tax is required :
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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 firat above written . ' ' ~ ~ ~ - - • '
F~ L R~0 ~E~URDED ~ ~
~ ST~UCtf. ~~UMtY FLA. .
P~c~ ~~rRas ~ .
y C~ERK i:~'..Usi ~OURT A~' '?Y\ ~ i~ :
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~ ~.~y ~ , . Ar~ ~ !2 4o PM'75
~ ~Sl~ Execut~ve Director ;
" _ Department of Revenue ;
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~ Not valid w?ithout seal affixed . 801 HARVEY BLDG. '
W. PALM BEACH, FLA. <
~ t 33401 ~ R p
BOOK~ PACE e~QO
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