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STATE OF FLORIDA
DEPARTMENT OF REVENUE
„~`""''~4 ESTATE- TAX BUREAU
.J
y - ~ TALLAHASSEE. FLORIDA 32304
o
""aav cot, ~a. NONTAXABLE CERTIFICATE AND RECEIPT
exECUnvt cuECroR
FOR ESTATE TAX
TO: Chelsea Title and Guaranty Company [ C O ~
800o south v.s. l E JU C,{~
Port S.t Lucie, Florida 33452
Re: The Estate of Ellsworth 1. VanSciver
Deceased.
Resident of Camden
County, New Jersey
Dst~e Oct. 4 , 1979
I =5.00 Fee Received:
{
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
I
~ Florida Statutes, there has been filed with this office a sworn report or return for Estate
e 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
1 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.
Given in quadruplicate under my hand and the seal of the State of Florida the
date first above written.
- ~
Executive Di ector
Department of Kevenue ~~511;3
~ILL~~;1~ ALL i';1 ! ~i
~r'CGER F :~~IT;:,~~;
Not valid without seal affixed . ` ` ~ ~
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