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STATE OF FLOR 1 DA
DEPARTMENT OF REVENUE
h'~a4 TALLAHASSEE. FLORIDA 32304
NONTAXABLE CERTIFICATE AND RECEIPT
FOR ESTATE TAX
RANDY MILLER
EXECUTIVE DIRECTOR
T0~ ~t.~ pr~a Ti tl E? Tna _ _nr= - RE: The Estete of (`a 1 1 en,, George W.
ggqQ C iiC 1aTaY 7 DECEASED 7~7~~77
-~r-~~e~-~,~4 cd Z RESIDENT OF COUNTY,
STATE OF
DATE:
Kathleen W. Callen, PR
E 90028 ,
¢ THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
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 detemnined 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 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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ROGER P011RAS
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