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FORM pR• 7p2
STATE OF FLORIDA
~EPARTMENT OF REVENUE
ESTATE TAX BUREAU ~
TALLAHASSEE. FLORIDA 32304
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! EO STRAt1GMN NON - TAXABlE CERTIFICATE AND RECEIPT
EaECUT~r( O~IIECTM
FOR ES7ATE TAX
TO: Edna Mae cook spouse C 9? 3 S 9
c/o Charles R. P. Brown, Atty.
P.O. Box 1418
Fort Pierce, FL 33450
R.e: The Estate of Guy H. Cook
Deceased.
- Resident of s~- _ r,ucie
County, _ Fio ~aa
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S5. 00 $~~8-Fee Received : _samp
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, there has been filed with this o~ce a sworn report or return for E9tate
Taxes as required by law and on the basis thereof it ha~ been ascertained the above estate
is not subject to the Florida Estate Tax .'Fhe issuance of this certificate, ho~?ever, shall
not preclude the assessment and collection of Estate Taxes subsequently determined to be
due the State of Fiorida.
If proof of non liability by the above estate for the Florida Estate Tax is required
by any person ihis 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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Not valid ~vithout sest affiaed .
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