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STATIKOF FLORIDA
DEPARTMENT Olt ReVENUE
TALLAHA~EI[. RLORIDA 3ZZ04
- NONTRXABLE ~ERTif iCA1E -AND RECEiP~
' RANDY MILLER .
EXECUTIVE DIRECTOR
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9aldwin - q~~~~ Brooksher, Elba C.
4u~tp 2nl Attan Rlrlg_ pE~~p 3-7-68
201 S. 2nd St. - RESIDENT OF Chatham ~Ty.
Ft. Pierces Fla. ~~4~~ BTATEOF GeOL~la
. owTE: 1-10-80
Maude D. Brooksher, PR E 7 5 6 3 5
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! - THIS IS TO CERTIFY, That -in accordance with the provisions of Chapter 198,
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Florida Statutes, there .has been filed. with thin, office a sworn report or return far Estate
Taxes as required by law and on the basis thereof: it has been ascertained the move estate
E is not subject to the Florida -Estate Tax, The i~uance of this certificate, however, shall
f not preclude the asse~ment and collection of Estate Taxes subsequently determined to be
E due the State of Florida.
If proof of non liability by the above`estate for the- Florida Estate. Tax is required
by any person this Certificate may be exhibited ~ evidence of such non liability.
6• Given in quadruplicate under my hand and the seal of the State of Florida.
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- , Executive Director
;S~ Department of Revenue
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Not valid without seal affixed. c~~tt A41A4J~ ~~R~;~ •r~r,;~
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