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FORM pR-]p~
` STATE OF FLORIDA
DEPARTMENT OF REVENUE
_ _ ESTATE TAX BUREAU ~
TALLAHASSEE. FLORIDA 32304
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1 EO STRAUGHN NONTAXABLE CERTIFICATE AND RECEIPT ~ :
EIIECUTWE O/R(CTpR FpR ESTATE TAX -
TO: Lester wor~cman, Exec. ~ 2 3 2 4 3
C/O Mr. James W. Thomas Co.
P.O. Box 330
Gtrard, OH 44420
, Re: Tl~c Escate of Dorcas Workman
Deceased.
Resicient of Tru~[tbull
Couniy, Ohio
Dace: _ November 19. 1974
$5.00 Fee Keceived :
THIS IS TO CEftTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, _ there has been fited with thia office a sworn report or return for Estate
€ Taxes as required by law and on the basia thereof it has been ascertained the above estate
i is not aubject to the Florida Eatate Tax . The issuance of this certificate, however, shall
~ not preclude the assessment and collection of Estate Taxea subsequently determined to be _
~ due the State of Florida.
,
g 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 seai of the State of Florida the
~ date first above written.
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Not valid without seal affiaced .
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