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FORM DR- 30I - ~
- • ~ ` STA~TE OF ~L4R~DA , .
" DEPARTMENT OF REVENUE ~ '
ESTATi E TAX BUREAU -
~ ' ~ TALLAHASSEE, FLORIDA 3?304 . ~ ~ ,
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~ Eo ST~~~~:~N NONT~XABLE CERTIFiCATE AND REGEIPT ~
~ ~ ~ EiECUTr1fE OIRECt011 - ~ . • ~ ~ ~
FaR EST~4TE TAX :
TO: Gaines & 5aichek Attys.
161 West Wisconsin Ave. ~ -
Milwaukee, Wisconsi n 53203 - ~ J PP -
_ . Re: The F,~:tate of ~ Daniel H. Berrong - ~
Deceasea. ~ ~ ~
~ ~ - Milwaukee ~
' - - Resi~ent of - County,
~ - - Wisconsin~ . ~
. : State of-
- May 30, 1975
- Date:
- . December 27, 1974 . ' `
- _ ~ SS.00 Fee Received: ~
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TNIS I~ TO CFRTIFY, That in accordance with the provisions of Chapter 198, _ '
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Florida Statutes, there has been filed with this of~ce a swarn report or return for Estate ~
Taxes as rea~uired by I~w and on the basis thereof it has been ascertained the above estate ~
is not sub~ect to the Flortda Estate Tax . The ~ssuance of thia certificate, however~, shall . ~
- not preclude th~ assessment and collection af Estate Taxes subsequently determined to be ~
~ due the State of Florida. ~ - - -
If proof uf non liabili~y by the above estate for the Florida Estate Tax ~s required ~
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by any person this Certi~cate may be exhibited as evidence of such non liabijity . ~
. Given in quadruplicate under my hand and the seat of t~e State of Florida the ;
date first above written . - - - .
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- _ ~ ~ : Executive Director _ ~ _ ~
. " { ; _ . ~ _ - Department of R.evenue ~ ~ _ - -
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Not vaiid without seal affixed . . _ - -
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