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RANDY MILLEF2
EXECUT~VE O~RFCTOH
STATE OF FLORIDA
DEPARTMENT OF REVENUE
TALLAHASSE~, FLORIDA 32304
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NONTAXABLE CERTIfICATE AND RECEIPT
~ FOR ESTATE TAX
• Harold H Goldman
T . ---
8028 S Federal Hwy
Pt St Lucie. Fla. 33452
Hugh Jencks, Spouse
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RE Tne Eztate of Jencks, 1''11Y'1dICi $ _
DECEASEO 2-10~"8i
HESIOENT OF St LllCI P_ COtiNTY
CTI~TC_ ~r r.~ _ ~ _
"•••' `- " C 1NZ 1(.Id
DATE
A 53145 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 requireci 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
r~ot preclude the assessment and collection of Estate Taxes subsequently determined ta be
due the State of Florida.
if proof af non liability by the above estate for the Florida Estate Tax is reyuired
t~y any persor~ this Certificate may be exhibited as evidence of such non liability.
Given in quadruplicate under my hand and th~ sea! of the State ~f Florida.
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+ ~ Executive Director
:~•• Departmeni of Revenue
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Not valid without seal affixed, ~;
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3-25-R1