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FORM OR- 3pt . .
STATE OF FLORIDA
DEPARTMENT OF REVENUE
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o,, ESTATE TAX BUREAU
~ ~ TALLAHASSEE, FLORIDA 32304
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1 ED STRAUGNN NON • TAXABLE CERTiFICATE AND RECEIPT
EtECU71VE UTAECTpq
FOR ESTATE TAX
TO:
Dollie Mae_ Adams, spouse
Mr. Moie Jo L. Tenrich p n R{;~ ~ rr
Attorney at Law
2240 Biscayne Blvd. R,e : The Estate of Willie C, Adams
Miami, Florida 33137
Deceased.
ftesident of St, r~ucie
Florida
County,
Date •
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$5.00 ~;~q Fee Received : August 2, 1972
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
Flurida Statutes, there has been filed with this office a sworn report or return for Estate
Taxes as required by law and on the basis thereof it has been ascertained the above estate
is not subject to the Florida Estate Tax . The issuance of this certificate, however, shall
not preclude the assessment and collection of Estate Taxes subsequently determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
' by any person this Certificate may be exhibited as evidence of such non liability.
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Given in quadruplicate under my hand and the seal of the State of Florida the
date first above written .
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: _ _ ~ _ Executive Director
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Not valid without seal affixed . 7
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