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ST4TE OF FLO~2IDA .
- DEPaRT!~AENT OF R~VEN!!~
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,~;,~~°r•~, . TALLAHASSEE, FLURIDA 32304
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NaNTl~XA6LE ~ERTIFiCATE AND RECEIPT.
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RANOYA!ILIER ~OR ESTATE TAX - .
EXECVT~VE OIRFCTOR
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. Joe T. I~Sartin, PA Rumlin, Caldonia R.
_ ~O ~ RE~ The Estau of
• PO Box 949 o~cEASEn 2-9-81
Lake ~1T11G'S FL 3:~853 ~~s~oENTOF p~l'}' COiJNTY,
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STATEO~_ F101iC~d
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t~ATf 9^8_82
Annie Lee Smith, Pers . Rep • . ~ ~ ~ ~ ~ U
THIS IS TO CERTIFY, That in accordance ::~ith the provisions of Chapter 198,
Flo~~~~ Statutes, there has heen fite~~with this office a sworn report or return far Estate
Taxes as required by law anci on the basis thereof it has been ascertained the above estate
- is not subject to the Florida .Estate 3ax. The issuance of this certiTicate, however, shall
not preclude the assessment and coilection of Estate Taxes subsequently determined-to be
due the State of- Florida. ~ - ~
~ !f prodf of non liabiiity by the above estate for ~he Flor~da Estate Tax is.required ~
- by a~}~ person this Certificate may be exhibited as evidence-of ~uch non liability.
t - Given in quadruplicate under my hand a:~d the seal of the State of Florida.
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S:.LUC~f Ctl~,\~'e.ri A,
I ~ ?~r~~t~~o~;r;,s Executive Director. -
j CLCttK C#l~CWT CL~~. ~
~.~'~'~~J Department of Revenue
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