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DR-309 ~On STATE OF FLORIDA ~ ~
~~9 DEPARTMENT OF REVENUE
Certificate of Waiver and Release of Florida Estate Tax Lien
Estate of Residence at time of death ~ Date of Death
- Melva Delbridqe Illinois 12-22-76
TO: Name an a ress o.App icant
Cliffe and Engel, Attys.
P.O. Hox ?43
DeRalb, Illinois 60115 _ -
I, here y certify t at the estate tax or the above named estate, has
been duly discharged or duly provided for. Wherefore and by reason whereof,
I do hereby issue this certificate waiving and releasinq the lien of the
State of Florida imposed by Chapter 198, Florida Statutes, on the following
described property.
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ignature Tit e ~ Date ~
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-1~ R. Glenn Dixon, Chief ~
tate Tax Bureau 2-21-78 eh ~
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