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Fiw~ K~ U. S. TREASURY DEMRTIiAENT = INTERNAI tEVENUE SElY1CE . M.
. i~v. r,av. i~u CptTiFlCATE OF R~EASE OF F~BtAI TAX LIEl+t. ' Y..
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OISTRIC7 • SERIAI tr1J/NSER
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- I hereby certify thot vs 1e the following•~amed taxpayer the ~equiremenfs of Section 63251c1 Intemal
• Revenue C'~ode of 1954, have been satisfied with respec~ to the taxes enumerated below, toget~er with
all statutory additions pravided by Section 6321; and that the lien for wch taxes and ~statutory additions
hos thereby been released. The prop~r of~'ieer in the of~'ioe where notioe of internoi revenue tax lien
- was filed on ~~r , 19~, is hereby catFwrized t~o make nototion on _ his books to show
the release of sqid lien, insofar as the lien relates to the foi{awing toxes. ' :
NAME QF TAXPAYER . • '
~ 'l+~BZ~~ii.~f~~~ti ~1~.'O:it~ ~ ~OZ1R~ . .
~ RE5109~KE OR PtACE Of 8tlSI .
TYPE Of TAX At~ PEWOD ASS~SSMEM QATE R~ERENCE NO. ~ ~i:
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941 vi~ains 3-63 T-1-63 f 59-a9'1~~99 i 133•6~2
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. tUC1E COUNt FLQRlOA p ~ ~ 1
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MA~CE Of fftll~lfs • .
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WiTNESS my ha~d at • J11~1C.9014VILLE~ liQRml .
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~ Lanris M. ?oali~oa '
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` RiOTE+ GefiooN of efioK owlwH~d b~r lar to tolr oe#nowMdO~M~ U nat wMNd 1~ Mr vaM~y ~f thN ~.M. G~. 19
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