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FORM OR- 302 .
• ~ STATE OF FLORIDA ~
DEPARTMENT OF REVENUE ~
° ~ ~ ESTATE TAX BUREAU ~
~ TALLAHASSEE. FLORIDA 32304
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J. EOSTRAUGNN NON-TAXABLE CERTIFICATE AND RECEIPT
EXECUTIVE OIREROR . ~OR ESTATE TAX .
TO: Dorothy H. Blackburn Heir at Law
c/o Chester E. Clem, Atty. C 9 6113 ~
P.O. Box 2397
Vero Beach, FL 32960
Re: The Estate of Albert H. Pettengill ~
~ Deceased. Fla. Prop. in St. Lucie
Resident of Mo roe `
County, Pennsylvania
DBte • Ma~ 22,1973
; $5 . 00 Fee Received S~e `
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~ THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198, ;
f Florida 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 ~
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~ 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. -
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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 Florida the
date first above written. -
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~.i. , _~~y~.,~w.~ EXeCUtIVe Director :
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Not vari~:. ~ hout seal affixed . _
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