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STATE OF FLORIDA
DEPARTMENT OF REVENUE ~~'~~a3
- ~ d ~ yi4 TALLAHA~EE. FLORIDA 3204
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NONTAXABLE CERTIFICATE AND RECEIPT
~„,,,,~R FOR ESTATE TAX
EXECUTIVE DIRECTOR
T0: Berrien Becks SR, Atty. RE-TI~Estaled Ansell, Elizabeth
PO drawer 2140 oECEwsED 5/22/80
_ Da=tnna Bch FL 320E RESIDE1rT OF ndi an Iii
ver
STATE Of ~1 nri e~~
DATE: 6 /6 /fIA
Ralph Ansell, Spouse -
E 88810
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutees, there has been filed with this office a sworn report or retium for Estate
I Taxes as required by law and on the basis thereof it has been ascertained the above estate
is not subject to the Florida Estates Tax. The issuance of this certificate, however, shall
not preclude the ass~nent and collection of Estate Taxes subsequently determined to be
due the State of Florida.
_ If proof of non liability by the at~o~re 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.
€ _
y Executive Director
s ` - 3 - Department of Revenue 4783
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Not valid without seal affixed.
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