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~ • Fonn bbf . U. S.TRfJ15l)RY DC~PARTMkM . NTERNAL REVBrU!- _y ' • far CM~w11Aw b R~ Wfka
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~ JaetNp~11L li~i,i~ 1~t7?63 O.R. 153 P 50 ST: ~UCIE COUNTY. FLA.
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1 I hersby certHy Nwt os to ths followin9-nomsd ta~aya? fhe requtre~r~snts of 5sdion 6325(c).
~ Intemol Rev~nus Gocl~, have been saHifisd with r~spat to the taxes enwnerotrd bdow, topetMr t Q ~IW~ ' i"~~ L~~~
~ wah all slot~tory odditio~~s provided by Sscfion 63~1i and that the tien for wch toxes ond v •
i uatutory odditior» hos thoreby been rslsosed. iM{~~~ office. in the affios wh~re rqti~e of ~~i ~~~j
i interral twMfus lox qsn wos filed Au.g 1~+ , 19 ~ is hereby
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~ autFwrized to moke ndation on hii boob fo slww ths rolease of ~id lien. ~nsofar es tha !»n iJ =•0'. T:? S
' ~°~°re~ to th~ folb"'i"q'°'~e~ CLtRK CtRCUtT COURT
j NAME Of TAXPAYBt
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~i.~ B.ac i]35
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i C1A55 OF TAX UNPAID BAIANCE
~Tox Rsturn Fom+ Nal PBt1o~ E7J0~ /?SS~SS~AeJI' ~A7E ID9~mFlfIPIG PwMBER oF wssESSN?Fi~tl
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PI.ACE OF FlUNG
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WlTNES~S my hand o+ Jackaonville, Florida - ~~~~5~
the 28 ~Qy of February 19 ~
DlSTRIGT DIRECfOR OF INTE'ANAL RENB~IUE BY Sipnofursl i1TLE
A. 'J. O~DONNII,I,, JR. SpgGi~! Procedures SecOan
R'10~E~ CKtfflcate of offiar autkorfsrd by !aw ro toln edyrr~snfs h no1 asNntla! to ths validity of thls documrM. G.G/lll 26419. GB.
1950-i, 125.) O R
PART 3--To be used for recording purposes SOOK PA~~
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