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~ STATE OF FLORIDA vc~13Q R. J
DEPARTMENT OF REVENUE
v~jtHEST,~lt TALLAHASSEE~ FLORIDA 32301
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~ HONTAXABLE CERTIFICATE AND RECEiPT
RANDY MILIER FOR ESTATE TAX
EXECUTIVE OIFiECTOR
TO: Patricia J. Brown, Esq. Hendron, John E.
R E: TM Estats of
2477 N.E. Dixie Highway gpC~ALSECURITYNO. 295-03-7950
Jensen Beach, FL 33~57 DATEOFDEATH: 7'29'~1
HESfOENT OF Col ~mhi ana COUNTY,
STATE OF Ohi Q
DATE: 1 2-17-$4
Katherine Hendron, Surv., Spouse
G 54574
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` 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 reiurn for Estate
~ Taxes as required by law and on the basis thereof it has been ascertai~ed 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 subs~quently 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 sea! of the State of Florida.
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~ • ; ~ , . ~ : Executive Director
~ , - : ~ , Department of Revenue
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Not valid without seal affixed. I~~k POIT:cA :~:=:Rt~
IUCIE CG.1rlT f. ~1,.
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