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(y STATE OF FLORIDA
DEPARTMENT OF REVENUE
~~..`~~ES"''~q TALLAHASSEE. FLORIDA 32304 s.
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HONTAXABLE CERTIFICATE AHD RECEIPT
RANOYMIIIER FOR ESTATE TAX -
EXECUTIVE DIRECTOR
TQ; Chelsea Title RE: TheE:uteof Novack Max
$OOO U. 1 DECEASED lO-~6-7H
Pt _ St _ L.Leie , Fla. 3 34 5 2 RESIDENT OF . COOk COUNTY,
STATE OF Ill i nn.i c
DATE: lI-ZZ-BQ
Jennie Novack , PR E 8 4 4 4 6 ~
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THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
f 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 Eertificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida. 'j
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s .l Executive Director
Department of Revenue
Not valid without seal affixed.
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