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I N RE : „TA~`K L. ROGERS
NON-TAXABLE CERTIFIGATE
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FORM (~p. 7~2
STATE OF FLORIOA j
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OEPARTMENT OF REVENUE
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_ ESTATE TAX BUREAU
~ r TALLANASSEE. F LORIDA 32304
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1 f0 S?RwUGNV ~•~lpN -'fAXABIE CERTiFICATE AND RECEIPT
f aECU~~~E u~RfC~~M
~ F~R ES7ATE TAX
TO: Lucy Jane Rogers Spouse C 1 J 6 8 4 3
c/o Mr. WilZiam F. Willes, Rtty.
P.O. Box 309
Fort Pierce, FL 33450 The E9tate of
~ Jack L. Rogers
Deceased.
Resident of St. Lucie
('ounty; Florida
~te. November 29, 1973
55.00 ~1-aQ-Fee Received: same
THtS IS TO CERTIFY, That in accordance with the provisiona of Chapter 198,
Florida Statutes, there has been filed with this affice a sworn report or return for ~atate ~
Ta~es as required by law and on the basis thereof it has been ascertained the above estate
is not subjpct to the Florida Estate Tax. The issuance of this certificate, however, ahall
nc,t precl~de the assessment and cotlection of Estate Taxes subsequentty determined to b?~
due the Sti~te of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required ~
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by any per~on this Certificate may he exhibiLed as evidence of such non liability. _
Civen in ~ quadruplicate under my hand and the seal of the State of Ftorida the -
date first ~ a~ove-~?~ritten.
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~ - ~ _ , - , .,~xecutive Director
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Yot vafid Mithout seal affixed . ~
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WILLES, BITTAN & WILLES " -
P. O. BOX s0~
FORT PIBRCE. FLORIDA 9J480 a~j~K M~~f I;~L~ ~~;r,{~
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