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fMw Ki U. S. ASURY DEPARTMENT • 4NiERNAt REVENtiE SERYICE
~REV. wov. i eai ~ CERT~IC~,~'E OI° R~EASE ~F FED~L TAX LIEN f~~'.
(Fortra~l~r fprrr~ 669 (T~ b~ ~ad N~M~S T~: ltsns wniw, SaM~w 6~l~d. l.R.C. of 1154!
DOSTRIC~ SERIAL NUMBER
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1 hsreby c~e~tify thot os t~o the followirx„~~~ed taxpayer the require~tenti of Section fi325{a!, Intetnal
Reven~e Code.'Qf 1954, hove been satisfied with respett to the taxes ~nur~erated belaw, together with
all statutory odditions provided by Sectian~l; and that the lien for such f~axes and statutary additions
has thereby b~en neteased. The proper ~ew' in the ofFice where r~ofice of inte~nal rev~nue tt~x lien
was filed on .~Pt~*~r ~7 • , 19~~, is hereby outhorized to rnoke notation on his books to. show
the release of ~id iien, insofar as the {ien-~elates to the fo{iowing taxes. +
NAME OF TAXPA i ~
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aES~oer~cE oa ~uc.~ c~ eus~~ss . .
rr OF TAX AN1D PERi00 dATE REFERETKE NO. l1MOUNT OF ~
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Fl E AND R~C ~ R. ~
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. _ . 4: . " ~0 ER P017Fi L RK ? ~ :
_ T. LUCI OUNTY' i
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WITNESS my Fiand crt ~~?~ksonv~lle, Florida ~ ~
the ~3rd. day of Norembex 19 b4
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DtSTRICT DlRECfOR aF UVTERNAI REVEtVUE dY ' .+nl 71TLE
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L~?urie W. To~lineon Speciai Procedures Sectfl~
(HO~'E, e.rn~cO» ~f o1RC.. owe~o.u.a a, law w ta+w ,ar .uene~al +o rn. va~idiry of th~. ~ 9, c.e. ~i zs.)
bh 'ART 3- To b~ used fo~ neordinq puryosts .
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