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STATE OR Ih.ORIDA
DEPARTMENT O~ REVENUE
- ""'d?i TAt.LAHASSEE. FLORIDA ~Z~4
. : N4NTAXAB~E C~RT~FIC~TB-AND RECEIPT .
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Rrwov M~«eR FAR ESTATE ~T
EXECUTIVE DIRECTOR
j'Q;BPtty J. Baldwin aE:Ti+.E,~aa O'Connor, Charles T.
y0i 2nd St. - uecEwseo 3-29-79
e,.; +e ~ n i RES~oENT of Wayne op~y.
Ft, pierce. Fla. 33450 aT~tEOF t~fishiS~n
W1TEL 1-2$-$0
Mattie Lee 0' Conner , PR E 7 s 9 ~ 7.
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~ THIS IS TO CERTIFY, That in aa;ordance with the provisions of Chaptier 198,
Florida Statutes, there has been filed -with this office a sworn report oc naum for Estate
Taxes as required by .law and on the basis thereof it has been ascertained the above estate
is not subject to the Florida Estate Tax. The issuance of this certificate, however, shall
not preclude the assessment and collection of Estate Taxes.subsequently detenmined_to be
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 as evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida.
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Executive Director
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~L~~;r ~ ~ Department of Revenue
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Not valid without seal affixed. ~z~~t ~u+RSVrR~F~n---__
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