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FORM R G•6i4 ~W~~ ?
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TALLAHASSEE ,
FR~D O. DICKIN~ON. JR. `~~04
Cont'rwoti~t ?
NON-TAXABLE CERTIFICATE AND RECEIPT ~ 23759
FOR ESTATE TAX
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Tp• Vivian 8. May, Spouae gE; ~ Samuel May
c% Mr. Charles R.P. Brown
~Attorney at Law
P.O. Box 1418 Resident of Lake
Fort Pierce, Florida 33450 .
~~ty~ Ind iana
September 22, 1969
( ;1.00 Fee Reoedved: Same
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~ THIS IS TO CERTIFY, T~tt in aooorclance with d~e provisions af Chapt~er 198, Florida
E Statutes, these has been filed with this office a swa~n repart o~ return for Estate Taaes as
required by law and on the b~sis t~ereof it has been a~ned tl~e above estate is not
subject to the Florida Estate Taa. T~e issuanoe of this ne~Hficate, hawever, shall not pre- .
ciude the asses~nent and eolled~ton of Estate Taaes subsequendy determin~d to be due the
State of F1orlda. '
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If pmo~ of non liability by the abave estate for the Florida Fstate Taz is required by
any person t},is Certificate may be e~hibited as evidenoe o~ such non liability.
~ G~s~a. in qusdn~Plicate undear my hand and seal the date first above writte~. ~
- : ` FRED O. DICBINSON, JR.
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_ - R~COR~ Y~RIFIED ;
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xot ~~~~~ut seal affi:ed. '69 SEP Z q~+! t I: 3 0 ~
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CIERK CIRCUIT COURT. ,
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