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FORM OR• ]02
STATE OF FLORIDA
DEPARTMENT OF REVENUE
St''~' ESTATE TAX gUREAU 2~39'~s
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" ~ TALLAHASSEE, FLORIDA 323Q4
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J EO STRAUGMN NON - TAXABLE CERTIFICATE AND RECEIPT .
f~ECU~~yE DiNEtTOw ~
FOR ESTATE TAX
TO• Helen S. Martin• Execx.
c% Shelby D. Wallis, Atty. A 1716 9 PF
2745 E. Atlantic Blvd. ~
Pompano Beach, FL 33062
R,e : The Estate of Ralph Martin
Deceased . Fla . Prop. in St. Lucie
. co.
~ Resident of Suffolk
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; County, New York
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; J~te • January 23 , 1974
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; $5.00 $~-04-Fee Received: January 18, 1974
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~ THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
~ Florida Statutes, there has been filed with this office a sworn report or return for Fstate
~ Taxes as required by law and on the basis thPreof it has been ascertained the above estate
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~ is not subject to the Florida Estate Tax. The issuance of this certificate, however, shall
~ not preclude the assessment and collection of Estate Taxes subseque~tly determined to be
~ due the State of Florida. j
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~ If proof of non liability by the above estate for the Florida Estate Tax i$ required
by any person this Certi~cate may be exhibited as evidence of such non liabitity.
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~ (~iven in quadruplicate under my hand and the seal of tfie State of Florida~ke
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= date first above written . .
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. Executive Director
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~.j Not valid without seai affixed . 2~39'7S
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