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FORM DR• )02 ? ~ - .
. ~ STATE 4F FLORlDA
OEPARTMENT OF REVENUE
° ESTATE TAX BUREAU
~ TALLAHASSEE. FLORIDA 32304
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J EOSTR~UGNH NON-TAXABLE CERTIFiCATE AND RECElPT
Er[c:1*wE o~*ECTOw
FOR ESTATE TAX
TO: Blanchie Davidson spouse C 9 9 2 6 y
c/o Mois J. L. Tendrich, Atty.
2240 Biscayne Blvd.
Miami, FL -33137 .
r • R,e : The Estate of Henry Clayton Davidson
Deceased.
Resident of st. Lucie
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County, Florida
~ j~te ; July 19 , 1973
~ S5. 00 -~-t;~ Fee Received : S~'e
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THIS IS T4 CEftTIFY, .That in accordance with the provisions of Chapter 298,
' 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 estat~
= is not subject to the F'lorida Fstate Tax . The issuance of this certi~cate, 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 f~:state Tax is required
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; by any person this Certificate may be exhibited as evidence of ~uch non liability.
_ (~iven in quadrnplicate under my hand and the seal~of the State of Florida the
= date first above written . " ,
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C~ ~
F.xecutive Director
` ~ Department of Revenue
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+ - ST ahD AECORDED
- ROCfF~OUhTY p~A.
_ . _ CLERK CI.~~ 0?TRAS
' RFC~~~ y~~ ' ifp CQURt ~
; aCl 13 a
S 3 A~!'73
~ Not valid without geal affixed .
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