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STATE OF FLORIDA tt
DEPARTMENT OF REVENUE
~~dTMS~'~4 TALLAHASSEE, FLORIDA 32304 4~
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NONTAXABLE CERTIFICATE AND RECEIPT
RANDY MILLER FOR ESTATE TAX
EXECUTIVE DIRECTOR
T0: Chelsea Title & C.Laran ,y co _ RE:'The Esua of JBs
ke ~ Wi 1 7 a i n+ H,
8512 S . U$ 1 DECEASED l A /2?T72
Pt St _ t.tsn i a ~ Fj, ~ 3d S 2 RESIDENT OF s~ ~~~o},Q COUNTY,
STATE OF
DATE:
Eva Japke, Spouse
E 90964.
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~ 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
E 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
I by any person this Certlflcate may be exhlblted 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
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Department of Revenue 49291
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Not valid without seal affixed. "E~
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