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STATE OF FLORIDA
DEPARTMENT OF REVENUE
d'""''~ ESTATE TAX BUREAU
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- ~ TALLAHASSEE. FLORIDA 32304
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""RR" cot. ~R- NONTAXABLE CERTIHCATE AND RECEIPT
execunve otReeTO~
FOR ESTATE TAX
TO: Marie Fifer, spous-e
C/O Frank j. Kozelka E 5 3 ~ 3 3
The Stafford Building .
6588 Breckville Road
Independence, Ohio 44131 Re: The Estate of Fifer.Glen
Deceased.
Resident of Cuy ahoq a
County, ah i n
Date: SeFt. 5, 1979
E5.00 Fee Received:
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THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
~ Florida Statutes, there has been filed with this office a sworn report or return for Estate
' Taxes as required by law and on the basis thereof it has been ascertained the above estate
is not sabject to the Florida Estate Tax . The issuance of this certificate, however, shall
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not preclude the assessment and collection of Estate Taxes subsequently determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
by any person this Certificate may be exhibited as evidence of such non liability.
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Given in quadruplicate under my hand and the seal of the State of Florida the
date first above written .
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.~~:.Y.. ~-1 Executive rector
, . 462511
a _ , - : - 3. ~~1. Department of Revenue
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Not valid without seal affixed. -
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