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M ` hs 66i u., S. TREASt1RY DEPAR?iN~~ . IrtfE~NA~ IlEVe~l1E 3lIN1CE • ~ ' w orr~11M b ~«w~ d'ltw
~ I~v. s-~1 CERnFlCJ1TE ~F RELF~ISE ~F FEDERAl. ~AX-LlE11
~ an~~ RILED AND R~CORB~O~
~~yy IS775~2 B 16T P 221t T. LUCIE COUNTYi l.A.
~~y ~sr,ity that Q, w,h, tolbwt~p.~+on,sd tmy~, tl,. r.qu~~,Mns of s.aion 692staL R F- C 0 R D V E R I F I t 0
Intsrnal R~vsM:: fjod~. how b~en wtiifled with ersMd !o th~ fox~s ~aNd b~low, top~fh~r 163814
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am„ro^, uaaiHons !aa thsr.br bsen rsl.assa. Tt~. propw officer u, th. offla.6w71r~. ~wnc.
inlsmol rev~n~+s tox Ibn was filed ei+ JUl ~ 19----. b h~~+b~r
o~,tl~ortzsd to moks naattoe on his books to slaw th~ nlea~s of soid (Nn. Nuohar w th~ li~n °
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ru?~ oF r~w~e l&RK CiRCU1T COURT
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CL/5S OF TAX UNPAID Mi/1NC,E
(Tmc Retvm Fwm No.) PptiOD BrGED ASSBSMB~IT QATE IDBJ~iFYIAK's MulAOER OF /1558SMBJ~
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WITNESS my hand et Jackaonville~ Florida on thi:,
1? January 68
the day of ,19
DISTRlCT DIR6GTOR OF IMEilNAL RfVB~lIJE 6Y TITIF
A. J. O~DONNELL, JR. ~ Chiei~Special Procednree
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~lOR& C~rtlflaol~ d offiar wthorind hY law to tob b nof ~swnMal !o th~ wlidiryr of ~?IR G.CAIL ~k419., CQ.
_ 1950.1. 145.) ~f ~
PART 3-To b~ us~d ~ ne~r+ellnfl P~+~~
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