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STATE OF FLORIDA
DEPARTMENT OF REVENUE ~
;J a~¦ ~ TALLAHASSEE. FLORIDA 32304 _ #
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HONTAXABLE CERTIFICATE AND RECEIPT - F
RANDY MILLER - FOR ESTATE TAX
EXECUTIVE DIRECTOR
TQ; Rov F . McGeadv. Attv . RE: TM Eaaa or Ollhauaen, Leo -
121 Rochell Ave. DECEASED 3/.2179
Rnr_hEall ark' NT t176b2 RESIOENTOF $prrtan COUNTY,
STATE OF
DATE: iQn
E 81644
Nellie Ollhausen, Exec. -
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
Taxes as required by law and an the basis thereof it has been ascertained the above estate s
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 Florid..
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
f r ' - Department of Revenue 4135
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~ Not valid without seal affixed. ~'s`'E"'r'~-
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