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STATE OF FLORIDA
DEPARTMENT OF REVENUE
`~.,~`~E'T''+~ TALLAHASSEE. FLORIDA 32304
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HOHTAXABLE CERTIFICATE AHD RECEIPT
RANDYMIIIER FOR ESTATE TAX
EXECUTIVE DIRECTOR
T0; Frances B Blackburn RE: TheEsateof Blackburn, George A
3~ 21 S Indian River Dr ~ DECEASeD 10-4- 79
Ft Pierce, Fla. 33450 RESIDENT OF St Lucie couNTY.
STATE OF Ft orida
DATE: 9 - S - SO
Francis B Blackburn, spouse A 51150 PP
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 iL 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 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 seat of the State-of Florida.
_ _
Executive Director
~ ~ . ~ Department of Revenue
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