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en- ~/~s STATE OF FLORIDA
DEPARTMENT OF REVENUE
~d~E"~~4 ESTATE TAX BUREAU
~ ~ TALLAHASSEE. FLORIDA 32304 •
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""RRY w~, ~R. NONTAXABLE CERTIFICATE AND RECEIPT
EXECUTIYE DI~EC?OR
FOR ESTATE TAX
TO: Arvid W. Dahlstrom, Spouse .
A ~ PP
c/o Olmpic Title & Abstract Co.
P .O . Box 3719
Ft. Pierce, Fla. 33450 Rc: The Eecace of Carolyn D. Dahlstrom
Deceased.
Res;dent of Fairfax
County, VirQinia
Date: 4-10-78
. :5.00 Fee Received: 3-29-78
! THI3 IS TO CESTIFY, That in accordance w?ith the provisions of Chapter 198,
~ Ftorida 3tatutes, there has been filed with this office a s~?orn repoct or return for Estate
; Taxes ss required by Isw and on the basis thereof it has been ascertained the above estste
~ is not subject to the Florids Estste Tax . The isausnce of this certificate, how?ever, ahall
~ not preclude the sasesament and collection of Estate Taxes subsequentiy determined to be
~ due the 3tate of Florids.
If proof of non lisbility by the above eatate for the Ftorida Estate Tax ia required
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~ by any person thie Certificate may be exhibited se evidence of such non liability.
Given in quadruplicste under my hand and the sea! of the State of Florida the
~ dste first sbove ~?ritten.
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~ Depirtment of Kevenue
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~ Not oal~d without sesl sffized .
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