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STATE OF FLORIDA
DEPARTMENT OF REVENUE
~'..°~1>,E~''~9. TALLAHASSEE, FLORIDA 32304
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NONTAXABLE CERTIFICATE AND RECEIPT
RANDY MILLER FOR ESTATE TAX
EXECUTIVE DIRECTOR
T0~ C. Norris Tilton RE: TheEststeof Holmes, Samstone
P. O. BOX 526 t DECEASED 2-19-8U
Jensen Beach. Fla. 33457 RESIDENT OF St LllCle COUNTY,
STATE OF ~'l nri r]a
GATE: 5-~ 9-SO
Jeanne Holms , Spouse E 8 715 O -
THIS IS TO CERTIFY, That in accordance with the provisions of Chapter 198,
Florida Statutes, there has been filed with this office a sworn report or return 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
s not preclude the assessment and collection of Estate Taxes subsequently determined 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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Not valid without seal affixed. '-t`" cs.-_°!r `.t`"`T~
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