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FORM OR- l02
STATE OF FLORIDA .
DEPARTMENT OF REVENUE
ESTATE TAX BUREAU
~ TALLAHASSEE.~LORIDA 32304
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J EOSTftAUGHH NON-TAXABLE CERTIFICATE AND RECEIPT ~
[~ECUtWC WOECTd1 FpR ESTATE TAX
TO: Wayne W. Litchfield Petitioner
c% Abstract & Title Corp. A 2 0 5 5 4 PP
P.O. Box 3696
Ft. Pierce, FL 33450 The Estate of Cleo Helen Litchfield -
iiecea~ea . - -
- ~ Resident of s t L.LC ~ e
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County, Florida
I~ ~ Date: sul,y 30, 19'74
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~ $ 5.00 $~~:~9A Fee Received : JLne 12 , 1974
~ THIS IS TO CEftTIFY, That in accordance with the provisiona of Chapter 198, ~
Florida Statutea, these has been fited with this office a aworn 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 th~s certificate, however, shall
not preclude the assessment and collection of Eatate Taxes subsequently determined to be
due the State of Fiorida. - ~
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 Lhe seal of the State of Florida the
date first abw~~,~rtit~en.
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Not valid without seal affixed .
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