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iORM OR- ~02
STATE OF FLORIDA
DEPARTMENT OF REVENUE ,
ESTATE TAX BUREAU
TALLAHASSEE. FLORIDA 32304 26(~~QS
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J. EO STRAUGNN NON • TAXABLE CERTIFICaTE aND RECEIPT
FOR ESTATE TAX
TO: Agnea M. Ford . sgouse C 9 9 3 4 4
c/o Charles R. P. Brown, Atty. ~
P.O. Box 1418
Fort ~ierce, FL 33450 The Estate of
~ Charles A. Ford
Deceased.
Fla. prop. in St. Lucie Co.
Resident of a~ ~~rk
COU1'lty, ~P~ Ynrj~ ~
Date: Jul= 20, l°73
S5. 00 $~88-Fee Received : ~a~.~
THIS IS TO CEBTIFY, That in accordance with the proviaions of Chapter 198,
Flor~da Siatutes, there has been filed with this office a~worn 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 coilection of Estate Taxea subsequently determined to be
due the State of. Florida. r
If proof of non liability by the above estate for the Florida ~:state Tax is required
by any peraon this Certificate may be exhib~ted as evidence of such non liability.
Given in quadruplirate under my hand and the seai of the State of Ftotida the
date first above written.
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~ " w~.' ~~..~.,1 ~ Executive Director 260445~
' ~ ' • ~ • Department of Revenue
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~ . } ' ~ • - . S~LIUCIC COUNfY FLA.
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` Not valid w?ithout seal affixed .
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