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~Zr6S4Sa3 STATE OF FLORIDA wQC~~'~„ .
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DEPARTMENT OF REVENUE 8 NNt~ ~
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, ESTATE TAX BUREAU ~EtflRO Y[R?~~~e
TALLAHASSEE. FLORIDA 32304 pN 1'3
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1 ED STFtAUGNN NON -TAXABLE CERTIFICATE AND RECEIPT
EiECUT•vE O~nEC~c~ FOR ESTATE TAX ~
TO: ~nabe~le P. ~larke spouse C 10 3 4 2 5
c/o Abstract & Title Corp.
P.O. Box 3696
Fort Pierce, FL 33450 The Estate of
• ~ Louis E. Clarke
DeceasedFla. prop. in St. Lucie Co.
Reside[tt of Wa~nP
COURty, Michiq n _
Dgte : netoher 2~ 7 97 ~
$5. 00 $}.-p¢ Fee Received : same
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
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
is not subject to the Florida Estate Tax. The issuance of this certificate, however, shall
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~ not precluc3e the assessment and coilection of Estate Taxea subsequently determined to be
E due the State of Florida.
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- If proof of non tiability by the abo~ e estate for the Florida Estate Tax is required
hy any person this Certificate may be exhibited as evidence of such non liabi[ity.
F
; t~iven in quadruplicate u~der my hand and the seal of the State of Florida the
s
F date first above written.
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; Not valid ~vithout seal affixed . -
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