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STATE OF FLORIDA
DEPARTMENT OF REVENUE
~y~"+E ~'+4 TALLAHASSEE. FLORIDA 32304
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NONTAXABLE CERTIFICATE AND RECEIPT
- RANDY MILLER FOR ESTATE TAX
EXECUTIVE DIRECTOR
Ronald M. Cohen, Per. In Poss. Hathcock, Jeff C:
T0. RE: The Esat. of
5549 Lee Hwy. DECEASED 2-21-~I3
Arlington. VA 22207 RESIDENT OF Fairfax ~~y,
STATE OF _ Virgini8
DATE: - 7-29-HO
~ 50741 PP
~ THlS 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 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 Certificate may be exhibited as evidence of such non liability.
_ - -~aiy~t;-iA,-quadruplicate under my hand and the seal of the State of Florida.
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~ ' Executive Director
~ ~ - Department of Revenue 455
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RECQREt ti~^F~iEO_,_ COl~itt
' Not valid without seal affixed.
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