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FdRM DR- 302 ~ ~
STATE OF FLORIDA
DEPARTMENT OF REVENUE
° ESTATE TAX BUREAU
~ ~ ~ TALLAHASSEE. FLORIDA 32304
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J. ED STRAUGHN NON - TAXABLE CERTIFICATE AND RECEIPT
E7lENT1VE 01RECTOR FOR ESTATE TAX ~
TO:Julie C.Holmberg spouse
~ c/o charles R. ~ P. Brown, atty. C 9 4 9 7 2
P.O. Box I418
Ft. Pierce,FL 33450
Ke : The Estate of Robert s. Holmberg
Deceased .
Resident of st_ r.~i~i p
CpUlity, Fleri da _
Dgt@' Mav ? ~ 7 973
$5 . 00 Fee Received s~mP
THIS IS TO CEftTIFY, That in accordance with the provisione of Chapter 198,
Florida Statutes, there has been filed with this office a aworn 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.
Given in quadruplicate under my hand and the seal of the State of Ftorida the
date first above written.
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- : - - Executive Director
. - 4-_ Department of Revenue
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Not valid without seal affixed .
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