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FORM [T C-S14 ~
R[Y. AYO. t. 1lS~
1'76''7161 `
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FRiD O. DICKINfON. .111. ~
OOM~OLLiR
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NON-TAXABLE CERTIFICATE AND RECEIPT C 13623
FOR ESTATE TAX
T0~ Velma Baker, Spouse Re~ ~ Charles L. Baker, Sr. '
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c% Mr. Charles R.P. Brown j~, '
Attorney at Law ~
P.O. Box 1418 Resideat of St. Lucie
Fort Pierce, Florida 33450 ,
County, Florida
A~ril 9 . 1969
~1.00 Fee Reoedved: Same
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! THIS IS TO CERTIFY, T~at in acao~danoe with the provfs3~ons of Chapter 198, Florida
j Statutes, there has been filed with tbis offioe a sworn repo~rt a~ refiurn for Fstate Taaes as
required by law and on the basis thereof it has been asoe~ained the above estate is not ~
subject to the Florida F•state Tax. 1~e issuanoe of this oe~rtificate, l~owever, shall not pre- ~
clude the assessment and oollection of Estate Taxes subsequendy determined to be due the
State of Florida. ~
If proof of non liability by the above es~tate for t1~ Florida Estate Taa is required by ~
any person this Certifi~cate may be ezbibited as evidenoe of such non liability.
Given in qu~uplic~tte under my hand and seal the date first above written.
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L ~ ~ j-' ~ y ~ ~ ~ ; ~ FRED O. DICKINSON, JR.
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Not valid withu~ ~l affized.
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