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STATE OF FLORIDA ~
DEPARTMENT OF REVENUE
.,~'`""n'~ ESTATE TAX BUREAU ~
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~ _ ~ TALLAHASSEE. FLORIDA 32304 ~c^~~
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so:Tw?~~+r NONTAXABLE CERTIHCATE AND RECEIPT
ucauTwc a~ucr~ FOR ESTATE TAX -
TO: g,~~~ W. Pedersen, Ex.
A 32810 PP
c/o Abstract & Title Corporation
of Florida
Attn : Pat Neu Re: The Eatate of
P.O. Box 3696 Jessica R. Pedersen
Fort Pierce, Florida 33450 .
Reaident of Jeffersnn
County, T,gnnpiaspr~
Date: 5~~11~7
'i - :5.00 Fee Received: 4/8/77
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~ THIS IS TO CEIiT[FY, That in accordsnce with the provisions of Chapter 198,
` Florida 3tatutea, there has been filed with thia office s aworn report or return for Estate
~ Taxes ss required by isw and on the basis thereof it has been secertained the sbove estate
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' ie not subject to the Florids Estste Tas . The isausnce of thia certificate, how?ever, shall .
not preclude the sssesement and tollection of Estate Taxes subsequentfy aetermined to be
due the 3tatc of Florids.
If proof of non lisbility by the sbove eatste for the Ftorida Estate Tax is required
by any person thia Certificate msy be exhibited as evidence of such no~ liability .
Given in qutdrupiicste under my hand and the seal of the 3tate of Florida the
date firat sl~ve w~ritten.
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~,f~~". 1 _ ~ ~ -
~ . ^ Execut~ve Director
~ ~ ~ ~ - • ' : Depsrtment of Revenue
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~ ~ fllE.Q_ANO RECOROEC
• ~ , ST. ROCER OTqAS ~A ~
CIfRK CIRCUIt COURT ~
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