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STATE OF FLORIDA
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DEPARTMENT OF REVENUE -
..d'~~ "'''i ESTATE TAX BUREAU
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TALLAHASSEE. FLORIDA 32304
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""RRY co~.'R. NONTAXABLE CERTIFICATE AND RECEIPT - ~
EXECIITiYE DIRECTOR
FOR ESTATE TAX
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• • E 49431
Re: The Estate of ' ''r' T • . ' ° "
Decxascd.
Resident of ' r"~
County, ' in'_' : ~ 7
Date: T,;;-, i~ ,
ES.00 Fee Received
'I'DIQ :Q T^ £E:~TIFY, Th_t :r. accosdassce vtstls :kt grovsssosss Qf C!sagter ~!4$,
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 subject to the Florida Estate Tax. The issuance of this certificate, however, shall
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
j b~? any person this Certificate may be exhibited as evidence of such non liability. `
Given in quadruplicate under my hand and the seal of the State of Florida the
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date first above written .
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~ - r- ~ ~ Executive rector
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Not valid without seal affized . ~,[ERl r-o?{-r~ ~As/,~\
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