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'~Y STATE OF FLORIDA
OEPARTMENT OF REVENUE
~d~E~~~4 ESTATE TAX BUREAU
~ ' b TALLAHASSEE. FLORIDA 32304
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H~aev co~. ~R. NONTAXABLE CERTIFICATE AND RECEIPT
exceurrve o~~ECroR
FOR ESTATE TAX
TO: poris G. Deering, Petit. E 113 9 fi
Lawyers Title Insurance Corp. ~
321 So 2nd St.
Ft. Pierce, Fla. 33450 Re: The Eatate of Hazel E. Grigsby
Deceased.
Reaideat of Arlington
County, Virginia _
Date: 4/13/7 8
~ s5.00 F'ee Received :
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~ THIS IS TO CERTIFY, Thst in accordance with the provisions of Chapter 198,
~ Florida 3tatutes, there has been filed with this office a sw?orn report or return for Estate
~ Taxes as required by law and on the basie thereof it hae been ascertained the above eatste
~ is not subject to the Florida Estate Tsx . The issuance of thie certificate, however, shall
not preclude the asseeament and collection of Eatate Taxes subsequentiy determined to be
due the State of Florida.
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~ If proof of non liability by the above eatate for the Florida Estate Tax is requited
~ by any pereon this Certificate may be exhibited as evidence of such non liability.
~ Given in quadruplicste under my hand and the seal of the State of Florida the
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~ date firet sbove w?ritten. ~
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~ Ezeeutivt ' eetor
Depsrtment of Itevenue
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~ Not oalid without scsl sffized. MAr ~ 3 41 P~'~Q
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