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RANUY MIILER
EXECUTIVE OIRECTOR
STATE OF FLORIDA
DEPARTMENT OF REVENUE
TALLAHASSEE, FLORIDA 32304
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HOHTAXABLE CERTIFICATE AND RECElPT
FOR ESTATE TAX-
TQ: Janet N Sagent '
Lawyers Title Ins. Corp
9999 S. Us Hwv 1
RE: The Estste ot Roux, Dominic J
oECEASEO 4-4-75
RESIDENT OF Lewistown
STATE OF ~[],~Qp
DATE_ ~ 1-9-SO
Marie Martha Roux, PR
A 52159 pp
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COUNTY,
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 precfude the assessment and coltection 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.
Given in quadruplicate under my hand and th~ seal of the State of Florida.
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