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8TATE OR FWRIDA g ~.ld-~ /94
G.~o:. O 5 Q DEPARTMENT OF REYENUE
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~ e f T A I. L A H A S S E E, F L O R I D A 3 2 3 9 9- 0 1 0 0 $ 1 o 4 4 s t,,, ,
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M~ to~ N4NTAXABLE CERTIFICATE AND RECEIPT
~ ~ FOR ESTATE TAX
~ TO: 1ST AHERICAN TITLE ~
2fl14 SE PORT ST.
IUCZE BLYD. -
PORT ST. IUCIE~ FL.
33452
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RE: The Estate of T O ll MA N~ R Q G E R il •
SOCial SeCU~ity NO. 7 T 6= 28 ~,6 6 04
D~te of Death: I 0/ 1 T/ 8 2
Resident of Rt IN County,
State of
~ VaU.dation Date: g 1/O 5/ 87
Issue Date: 0 z~2 d~ 87
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CERTIF~CATE NUMBER aa25o2~
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THIS IS TO CERTIFY, that ~n accordance with the provisions of Chapter 1g8, Florida
Statutes, there has b~en fited with this office a swom report or return for Estate Tax~s as required '
by law, and on the basis thereof it has been asce~tained that the above Estate is not subjecf to the =
Florida Estate Tax. The issuance of this Certifjcate, however, shall not prectude the assessment
and collection of Estate 1'axes subsequentty determined to be due the State of Flohda.
if~proof of nonllability by the above Estate for the Florida Estate Tax is required by any
person, this Certificate may be exhibited as evidence of such nonliability.
Given in tripiicate under my hand and the Seal of the State of Fiorida.
~ ~ - 81.a44~ ` .
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_ _ '87 t~R? -2 P 2 ~05 ~ ~ ~ ~
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