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- STATE OF FLORIDA
DEPARTMENT OF REVENUE
ESTATE TAX BUREAU
~ TALLAHASSEE. FLORIDA 32304
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H~aav co~. ~R. NONTAXABLE CERTIFICATE AND RECEIPT
EXECUTiVE OIQECTOt
FOR ESTATE TAX
TO: M-ary A. Rroughton, Spouse E 4 3~ 2~
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C/O Jordan Fields, Aty.
416 Balboa St.
Stuart, F1. 33494 Re: The Eatate of oscar Broughton
Deceased.
Residcnt of T?are
County, Georgia
Date : 5,/~~ 7 q
=5.00 Fee Received:
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; THIS IS TO CEftTIFY, That in accordance with the proyiaions of Chapter 198,
~ Fiorida Statutes, there has been filed with this office a sworn report or return for Estate
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i Taxes as required by law and on the basis thereof it haa been ascertained the above estate
` is not subject to the Florids Estate Tax . The iasuance of thia certificate, however, shall
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~ not preclude the asaessment and collection of Estate Taxes subsequentiy determined to be
~ due the 3tate of Florida.
~ If proof of non liability by the above eatate 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 firet sbove w?ritten.
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~ Esecutive Di ector
- , Depsrtment of Revenue
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~ ROGER P~`iRAS
- Not valid without seal atfized . CIERK CtRCUiT C~
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