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FORM OA-]0~ ,
, , STATE OF FLORIDA •
- , ~ ~EPARTMENT OF REVENUE
ESTATE TAX BUREAU
TALLAHASSEE. FLORIDA 32304
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J. EO STRAUGNN NONTAXABLE CERTIFICATE AND RECEIPT
FOR ESTATE TAX
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TO. cArtrude Tho-~as , Ad~ri n. ~ 2 4 5 7 7
c/o Jo~:n ~7. B~11, F~ttv. -
?nc~ ^inancial Flaza, Suite ?41~
Fort Laud~r~ale, Floric~a 333~31 Re: TLe Estate of
C~n]'q~ . 'r'elOP'~~~5
~CCeSB~.
Resident of Ramsev '
County, ~tinnesota
Date: December 10, 1974
~5.00 Fee Received:
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~ THI3 IS TO CERTIFY, That in accordance with the provisiona of Chapter 198,
~ Fiorida Statutea, there has been filed with this office a aworn report or return for Eatate
~ Taxes as required by law and on the baeis thereaf it has been ascertained the above estate -
~ is not subject to the Florida Estate Tax . The iseuance of thia certificate, however, ahall
~ not preclude the assessment and collection of Estate Taxes subsequently determined to be
~ due the Stste of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
by sny person this Cectificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida the
dste firat above written .
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Executive Director
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Department of Revenue
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~ Not valid ~~ri~~iee~ ~eal- affixed .
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