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STATE OF FLORIDA -
' DEPARTMENT OF REVENUE
~.,~~E""'+Q TALLAHASSEE. FLORIDA 32304
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NONTAXABLE CERTIFICATE AND RECEIPT
RANDY MILLER FOR ESTATE TAX
EXECUTIVE DIRECTOR
TQ~ -Rene Sacasas, Aty. RE:TNeE:ntsof Jackson, Ralph
7520 S. W. Red -Road, Suite E-2 oECEasEO 2-1-78
SO ] -h Ml mi ~ FL 3314 3 RESIDENT OF COOk COUNTY,
STATE OF inneSOta
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• 14-14 - / J
DATE:
Dorothy Jackson, spouse E 7 3 9 3 0
THIS !S 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 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
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.
~I
Executive Director
Department of Revenue
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Not valid without seal affixed. ~~~~~c
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