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Foam DR-3.^,6 STATE OF FLORIDA
R`~_ io:» DEPARTMENT OF REVENUE
y`~ ~ TMF sr'`~4 ESTATE TAX BUREAU
W y ' ~ TALLAHASSEE. FLORIDA 32304
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NON-TAXABLE CERTIFICATE AND RECEIPT
HARRY L GOE. JR FOR ESTATE TAX
[Y[CUTWE OIR[CTOR
TO: Joan Laychak Hawreluk, Surviving Daughter A 46792 PP
c/o Mr. William E. Moschell, Esq.
1209 Biscayne Bldg.
19 West Flagler Street
Miami, FL 33130
Re_ The Estate of Joseph C. Laychak
Deceased.
- Resident of Dade
County, Florida
Date: 3-4-80
s 5.00 Ree Received: 3-4-80
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198, Florida
6tattttes, there has been filed M~ith this office a sMOrn report or return for Estate Taxes as
required by law and on the ba:i~ titereuf it bas been ascertained the above estate is not sub-
ject to the Florida Estate Tax. The i_vuance 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-iton liability by the above estate for the Florida Estate Taz is required by any
perBOn this Certificate may be exhibited as evidence of such non liability.
~ Given in quadruplicate tinder mp hand and seal of the Statz of Florida the date first above
k written.
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xq~ Ezcwtire or
Q ~iV Department of Revenue
Not valid without seal affixed.
I HEREBY CERTIFY that the above is a true and correct copy as it appears from the re -
cords of thin office.
IN WI'T'NESS WHEREOF, I have hereunto act my hand and the seal of the State of Florida
this ~lday of March , A.D. 19~Q. -
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Michael L. Patter-son, Supervisor
Review and Math Audit
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