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STATE OF FloltlDA s
DErARTMENT O~ REVENUE _
* TAL.LAHASSEB. ln.OR1DA 3Zl04
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~ ~ ~ !!0l~T~?B~E c~aTt~~~TE AND. i~ECEIPT ~ ~ ,
' RANOY WLLEq FOR ESTATE- .TAX.
EXECNTIVE DIRECTOR > #
La 1L~lA ~or>D . Alanchee . l~r B . ~
QA99 S. ~S HMY ,1, DECEASED _ Z~18~??
RESIDENT OF w•,•••,r~~ C0IJNTY,"
STATE OF v---s- ,
DATE:
Ate. ~ . l~nchee, spore 7 7 714
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THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 998,
Florida Statutes, there has been filed with .this office a sworn report or return for Estate
Taxes as required by Isw and on the basis thereof it has been ascertained. the above estate
~ is not subject to the Florida Estate Tax. The iuuance of this certificatie, however, shall
not preclude the assessment and collection of Estate Taxes subsequently deternnined to be ;
due the State of Florida. ~ ~ ~
If proof of non liability by the above estate for the Florida Estate Tsx 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 Revenus f
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Not valid without seal affixed.
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