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- = STATE OF FLOR 1 DA
_ DEPARTMENT OF REVENUE
~ - TALLAHASSEE._FLO_
RIDA 82304 .
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- -NONTAXABLE ~E~t`~L~ICATE AND _ RECEIPT ~ -
- RANDY MILLER I:OI~- , r
EXECUTIVE DIRECTOR ~ '
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T0~ Harold 8. Goldawn, Atty. - ~ Tne ~ . Math; s, A. $dward
BO2S S F@d SNY ~ DECEASED 1~19~77
Pt St. Lucie, FL 33452 RESIDENT OF -COUNTY,
STATE OF Michigan - -
DATE: 1~17~80
Mary R..Mathis, Spouse _ -
E 76265
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THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
M Florida Statutes, there- has been filed with this office a swoFn report or return-for Estate
! Taxes as required by law and on the-- basis- thereof it has been ascertained the above estate
f is not subject to the Florida Estate Tax. The issuance of his certificate, however, shall .
not preclude~the as9essment and collection of Estate Taxes subsequently determined tc be
due the State of Ftor~da.
If proof~of non liability by the above estate for the Florida Estate Tax is required.
by any person this Certificate maybe exhibited as evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida.
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Y- . ~ s . ~ Executive Director
I -''~yA ~'r~
' j ~ Department of Revenue4'74'7s3
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Not valid without sea! affixed. ~C°''~vrs<:~~a-
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