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STATE OF FLORIDA
- - . DEPAATMENT OF REVENUE
• ' TALLAHASSEE. FLORIDA 32399-O1Q0
~atie D. Tucker NONTA~CABLE CERTIFICATE AND RECEIPT
_ ..;t~ve Director
FOR ESTATE TAX
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Social Security No. `+~~-2`?-a551
Date of Death: 11 / 20! 89
Resident of ~ T~ I~ County,
Siate of F
Validation Jate~ 12/29/89
~ issue Date: ~ 1/ 1 1/ 90
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& CERTIFICATE NUMBER A d7 8 2 2 5
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THIS IS TO CERTIFY, that in accordance with the provisions of Chapter 198, Flotida
Statutes, there has been filed with this office a sworn report or return for Estate Taxes as required
k~y law, and on the basis thereof it has been ascertained that the above Estate is not subject to the
F=!orida Estate Tax. The issuance of this Certificate, hawever, shall not preci~de the assessment
.-~r;d collection of Estate Taxes subsequently determined to be due the State of Florida.
~ If proof of nonliability by the above Estate for the Florida Estate Tax is required by any
;-~;rson, this Certificate may be exhibited as evidence of such nonliability.
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€ Given in triplicate under my hand and the Seal of the State of Florida.
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~ r~~, K E D TUCKER, E ECU IVE DIRECTOR
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