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FORM OR• )OJ
STATE 'OF Fl.OR1~A
OEPARTMENT OF REVENUE
o~ S~F
„ ESTATE TAX BUREAU 2`', !
~ o TALLAHASSEE. FLORfDA 32304 $
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f EDSTRAUG?~N NON-TAXABLE CERTlFtCATE AND RECEiPT ~
ExECU~~VE a•cc*ae
FOR ESTATE TAX ~
TO: Clifford H. McCormick Spouse C 9 716 3
c/o Abstract & Title Corp.
P.O. Box 3696 ~
Fort Pierce, FL 33450
Re : The Es#ate uf Kathleen McCormick
I}eceseed.Fla. prop. in St. Lucie Co.
F LE AND REC~lt~~~ '
t~.~~.~ER~~o,!~~A~ ~ Resident of Was$inaton
CLERK C.RCU?T 04UR'~ ;
IlECOa9 VE+UF~E~ COUltty, Pennsylvania ~
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1~ 3 ~ 1i~'i3 {
2~84 nate:_ Jun _ . , F
$5. 00 $r-pB-Fee Received : same
THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, there has been filed ~rith this off ce 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 preciude the assessment and coltection of Estate Taxes subsequentty determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is reqaired
by any person this Certificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seai of the State of Fiorida the
date first -above written.
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