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. ~~~~~/VV~ DR-302 ~
. 8TATE OF l10RlDA . A. ~ ~
~ DEPARTMENT QF REVENUE ~ y
' d~'"`:*+,E TAILAHA88EE, FLORIDA 32501
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~~~..,,~,c' NONTAXABLE CERTIFICATE AHD RECEIPT
RANDYMiLLER fOR ESTATE TAX
EXECUTIVE OIRECTOR
TQ~ Richard J. 88r1'OA - RE: TM E:taa of Pettersson, Bror A.
p.~. BOX 324G SOCIALSECURITYNO.lO2-16-9714
Wpct pal m Seach , FL 33402 DATE OF DEATH: 2~lOf H3
HESIDENT OF $t T.uc!i p COUNTY,
STATE OF F7 nr~.7a
OATE: ~ ~7T
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F 99971
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 retum 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 t
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. 4
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OR 410 PAGE 7`Jl ~ . . . . . ~ ' -
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