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STATE OF FLORIDA '
DEPARTMENT OF REVENUE
y~1NEit+~ TALLAHASSEE. FLORIDA 32304
~ HONTAXA6LE CERTIFICATE AND RECEIPT
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RANGY MILLER FOR ESTATE TAX -
EXECUTIVE DIRECTOR
TQ; Arif Parupla RE: The Esateot Bas eon, EttgenP
9999 U. I-Ilghwajj 1 DECEASED 2-3-77
Pt_ St. i.u~ic~e Fla_ 33457 RESIDENT OF St. LUCle COUNTY,
STATE OF Florida
GATE: 12-16-79
Novalla Bascom, PR E 7 4 6 5 4
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 subject to the Florida Estate Tax. The issuance of this certificate, however, shalt
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.
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~ Executive Director
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Department of Revenue
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ROGER POITR:IS
F Not valid without seal affixed. cirrmcl~cuacu:~t
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