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FORM Olt- ~02 I 7 2 I I 8 7 5 9~
STATE OF FLORIDA
DEPARTMENT OF REVENUE BOOK PAGE
a ESTATE TAX BUREAU
1~ TALLAHASSEE. FLORIDA 32304
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J. EO STRAUGHN NON -TAXABLE~ CERTIFICATE AND RECEIPT
EIICCUT~YE O~RtC70R FpR ESTATE TAX
TO: M~r9aret Adams Spouse
c% Mr. Lawrence W. Borns, Atty. w 18 7 5 3 pP
1639 8astings Drive
Deltona, FL 32763
Re : The Estste of i~reder ick K. Adams
Deceseed.
Resident of volusia
County, Florida
Dste: April 19, 1974
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i $ 5. 00 ~S~}: ~0 Fee Received : May 2 5, 1973
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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 aw?orn 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 thia certificate, however, shall ~
not preclude the assesament and collection of Estate Taxes subsequently determined to be
due the State of Florida.
If proof of non liability by the above estate for the Florida Estate Tax is required
by any person this Certificate may be exhibited as evidence of such non liability .
Given in quadruplicate under my hand and the seal of the State of Florida _the
date first above ~vritten. ~ p ANJ itECpR
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. : = Executive Director
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Not valid without seal affiaed . w =
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