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F-o~m DR l~6 STATE ~F FLORtDA ~~en~~K ~~.i'~Ej G6UR~ ~
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Rev. j~n ~~7+ ~iEPR1RT~v1F_NT OF REVENU~ ~
M~r i~ li ~4 pN ~y
~oE"`f s'~lEO _ ES7ATE TAX BUREAI~
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~~°~~~E~~`` NUN-TAXABLE CERTIFICATE ANa RECEIPT
Eo STA,?UaHN FOR ESTA7E TAX
. [7[[1:UTIV[ OIR[CMII ~
, T0: Heinz W. Ziegler, Exec. _
. C/O Cab1Fr and Ailderso;~, Attys . -
P.O. Box 23399
Ft. ~auderdale, FL 33307~ D 34914 _
Re. The Estate of -
- _ - Elsa M. Ziegler ~
; Dcceused. ~
` - - ' Resident of Browart?,_
Y Gou~ty, Flor. ida-
= ~ _ Date: May 2, 19 7 5 -
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~ S 5.00 F'ee Received : Mav 2, 19 7 5 -
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~ _ THIS IS TO CERTIFY, That in accordance with the provisions of Ch~pter I9$, Florida
6t~tutes, tliere has been filed with tliis office a sworn report or relurn for Estate Taaes ~s
~ required by law and on the basis tliereof it has been ascertained t}~e above estate is not sub• ~
,
ject to the Florida Estate Tax. ~ The issuance of this eertificate, however, sLall not preclude the
assessment and collection of Estate Taxes subsequently determined to be d~e the State of Florida.
- ~ If proaf of va~i liaLilicy by the above estate for the Florida Estate TaA is required by ant~
person this Ctertificate may be exhibited as evidence of such non liabilitp.
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~Gixe~i,~in-q~druplicate under my lia~i and seal of the Siate of Florida the date first abo4e _
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~ ' "r ' • ' Executive Director
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- - - ~.Y= - Departm~nt af Revenue
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Not vaMc'~without seal affixed. ~ " ~ _
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" ° I HEREBY CERTIFY that the above is a true and correct copy as it appears from the re- -
~ cords of this~~ office. ~ . ~ _ .
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~ WI1'NE~S ~THER~:4F, I ha~e hereunto set my hand and the seal of the State of ~lorida ~
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this ~
h day of Mav , A:D.19 7 5, ~
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, . : _ _ ' _ Chief, ~etate Tax Bure .
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, ~ . • ' 4 ~l~~K~~V ~~iGF~~~~ RECOFD AND RETURN 70
- . _ ~AMES A. G+BIER> .1R. ~
_ - - - - - ~ . 400 E. PR45PECT R0. ~
" : . . - _ ~ WUDERDALE, FLA.
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