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Fojfn DR-304 Randy Miller
Executive Director
~t~F~,~ FINAL CERTIFICATE
FOR INHERITANCE AND ESTATE TAX
i _ ~ STATE OF FLORIDA -
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• - TALLAHASSEE
To Mr. Guy S. Emerieh, Aty. Re. The Estate of Brunkhorst, Edna C.
P.O. Drawer 1447 Deceased.
Punta Gorda, FL 33950 Louis
Resident of St • County,
State of Missouri
Date: 5-23-80
William A. Brunkl`iorst, Date of death: 10-17-78
Per. Rep.
THIS IS TO CERTIFY, That in .accordance with the provisions of Chapter 198, Florida Statutes,
there has been filed with this office a sworn return for Estate Taxes as required by law in the above
named Estate and that the amount- of tax assessed by the State of Florida against said estate was
ONE HUNDRED TAREE AND 32/100
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~ Dollars
The total tax paid amounted to S 103.32
The total interest paid amounted to S 1.55
The total penalty paid amounted to S NONE
No claim for refund of the above tax, or any part thereof, is pending, and no refund has been
authorized.
Given in quadruplicate under my hand and the seal of the State of Florida the date .first above
written.
. ,
- Executive Director
s w~ Department of Revenue
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