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• rp. ~ls 15`7440
FILE~ ANO R~R~ABLE CERTIFICATE ~xsu o. DICJm~ISON, Js., co~tro~r
Q ~o ST. WCIE COUN'fY. FIrL~ID RECEIPT
RECORD VERIFIED .
~S~~4O -STATE OF FLORIDA ~ Q~O~~
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~6T ~~11N 27 ~ - 8 : [ i -~HASSEE
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C7'~t~
Et~uiR ~ 0{TRA~
CIERK CIRCUIT- COURT ~
Ta Mhe7ma Rlac~k Joh11 William Black~ Sr.
Fort Pierce, Florida No Administration
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es~d~~fFlorida. St. Lucie~y
surviving soouse
THIS IS TO CERTiFY, T6at a svvorn r~dun foz InLe~itenoe and F.ttate Tas has beea filed by the duly qualified ,
repc~esentative of tLe above named Estate; a~i . ths~t, after allowln,g all lawful deb#s and other deductions and
_ the statu esemption applicable it was asoertained that said Fstate waa not subject to Taz. The iss~anoe
of thi: o~te, hawever, shall not ptecluda tLe a~t and oollection of tazes aub~eqnendy deter~nined to ba
due the State of Floa~lda.
A~ p~ovWed nade: 8ectioo 1 Acb af 19~i1. aad Section 15. (~aPtes 1a01S. Aeb af 1903. t~ ceitl8a~e
~~Coanb? J~n~s~in~ Fitaoe war ~ed to pamit a 9a~t aettkmaot ae aooou~in~ 1~ tLs
Gfven in qu~drup~be und~ nry band and ~eal thb, y ai A. D.1~ 67 _
Comptrolle~'s he of =L00
Recx+fv~~~l~
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d00K~W P14CE~~~
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