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RANDY MIILER
EXECUTIVE OIRECTOR
TQ' Harold H. Goldman, Att~.
Reller, Margaretha P.
RE: The Esate ot
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$O28 $. Federal HWY. DECEASED 1~14~8~ ~
pt. $t. LUC1E.' * FL 33452 RFSIOENT OF $~ Mateo couNTY,
STATE OF California .
DATE: 2~12~51
Ludolf R. Wentholt, PR
.~ ~ F 10~07
THIS IS TO GERTIFY, 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 proo# 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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Not valid without seal affixed.
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STATE OF FLORIDA
DEPARTMENT OF REVENUE 51'7551
TALLAHASSEE. FL,ORIDA 32304
NONTAXABLE CERTiFICATE AND RECEIPT
FOR ESTATE TAX
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