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Fef~ bbs U. S. T~A9l1AY DEPARTMBJT - IMERNxI ~EVEPAE R1/KE e - far Op~lwel U» h R~ead:wy ONJa•~ ~
.~R~,. ..a5~ CERTIFlCIITE OF RELEASE Of FEDERAL TAX UEN. . .
DISTRIGT 3ERIAL. Nl1MBER
~~~s. l~f~ ~50891 oR 161 p b56 s~t
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1 hshby osrti{y that os w tM following•nomd t~mcpoysr the requtreenenb of Ssdion 6325(a), .~•t~,~'': ~f'!r't"~1
Int~rral R~rwe Code. have been sotisfied with ~sp~tt fo ths faxes enumsrol~d below, togetMt ~651/~s
~ w~r~~ aan,wry odd~r~~~ortded by 5ecrton 632~sond thar ths lisn far axh taxss and Q~'~i~':t[ 7 PM ! 2• ~ y
st addiHau hos rhe. bser~ .e~eo~d. Th. offi~er ~n ths offto~ wh~s nona. of V
( intNnd rw+twe tmc lian was filed o~ fl a n 1~ , 19~. is h s?
s b
y ~/f
outhorized to moke notation on his books lo slaw th~ releose of soid liay insofor as ths li~n ~O
~ relahs b tht followirg toxes. i, ~J~_:~_ i; :-(~i j R:.S
r,~cR~c ~~~eu~r couRT
NAME Of TAXPAYER •
E
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~iE510R~ICE OR PLACE OF BUSINE55
~ ~ ~ ~ ~
~SS OF TqX UNPAID BALANCE
(Tax Rehrm fortn No.) PERIOD ENDED ASSESSMBJT DATE IOENTIFYIN3 NUMBER OF ~55ESS~AHJT
I ~ (o) Ib) ld Id) lel
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~ !41 9~~id ~ 1~~•~
~1 1~,7L~s 2+~~l.6i ~!-~~l~ ~+~t
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~
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~ P`"`E QOI~'t
x~ TOTAI i
~ ~x
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~ Jackeon?ille, Florida on th~s,
WITNESS my hand at ~
~
~
~ the 6 day of ~b , 1 q 68
~
~ DISTRfCT DIRECfOR OF INTERNAL REVHdUE BY noturo~ ~
~ J. O~AOtiNSI~Z~ JR. pecial Procedures Sectio^
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(NOTE: Grtificots ot officer autFwrized by law ro take edgmenri is not ~ssential to ths wlidity ofOtF~ ~Qt- G.C.I~~~ ~j
1950-1, 125.) d~l~K~ ~l1 vAfi s~
~ PART 4-To bs nMin~d b~? SPS _
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