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STATE OF FLORIDA
• DEPARTMENT OF REVENUE
~ ~4 ESTATE TAX BUREAU
~ ~ TALt,AHASSEE. FLORIDA 32304 !
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~Y ~ ~R' NONTAXABLE CERTIHCATE ~?IVD RECEIPT
ncESUrnE oi~ccre.
. FOR ESTATE TAX
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E 43264
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• '•F'T'!'~; "1 _ i' 4 i ~
_ ' Re: The Eatate of ' - ' ' . ~ , - _
_ Deceased.
~ ~ - _ Rcsident of ' ,
Caunty , - ~ . ~ : ±
,
DatC: ' ~ ~ ~ :
tS.OU Fee Received:
THI3 I8 TO CERTIFY, That in ucordsnce ~?ith the provisions of Chapter 198,
Fiorida 3tstutea, there hss been fited ~?ith this office s sworn report or return for Eatate
Tsxes ss required by law snd on the bssis thereof it has been sscertained the sbove estate
ie not subjeet to the Florida Eetste Tsa . The iseuance of this certificste, ho~?ever, ahalt
not preclude the sssesament and collection of Estate Taxea subaequently determined to be
due the 3tate of Florids. ~
If proof of non lisbility by the above eatate for the Florida E$tate Tax is required
~ by any pereon this Certificate may be exhibited ss evidence of such non liability.
~ Given in qusdruplicate under my hand and the seal of the State of Florida the
~I dste first above ~?ritten.
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~ = Executive Di ector
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~ ~ ~ ~.;4~~ ~ Depsrtment of Revenue
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~ ~ ~ _ = 45108`7
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