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• STATE OF FLORIDA
DEPARTMENT OF REVENUE
~'~4 TALLAHASSEE. FLORIDA 32304
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NONTAXABLE CERTIFICATE AND RECEIPT
-RANDY MILLER FOR ESTATE TAX
EXECUTIVE pIRECTOR
T0~ Harold H Goldman RE: TheE:c.t.of - Butchery Roland
8028 S Federal HWjr DECEASED 11-~ 5-79
Pt St Lucie, F1-a_ 33452 RESIDENT OF Marion couNTlf,
STATE OF jnri i Ana
. DATE: ~Q - 1 O - R
Mary L Butcher, Spouse E 9 9?? 0
THIS IS TO CERTIFY, That in accordance~with the provisions of Chapter 198,
I 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
not preclude the assessment and collection of Estate Taxes subsequently determined to be-
duethe 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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ST.LUCtE CCUlrTY.fi~1
ROGER f'OITRAS
CLERK ClAC+JIT Cf,°'. ~
Not valid without seal affixed. I. r 4;
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