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h~ ~ U. S. TREASUICY DEMRTIMBd~ IN1ERl1AL tEYEMlE SltVICE ~ Iar AMt~ 1A» b~~~:OM1n ~
v. 4 CER'TIfIGATE OF ~ OF FEDEWIL TAX LIQI ~
asnact sm~ r~uMeet ~ - ~
? Ja~ri.dtl~ iso~~a a-ibi r-26a ~~?~,~s ?
1 hsnby arNf~r thot as to tl+s folbwin0-normd fm~payer fhs rsq~iremsnn of Sedion 6325(0), -
Internol Rrv~ Gods, how been aotiified with nsp~ct to tF?e ro:es enumerated bsbw. togerFw h
with all datutory oddiNons pravided by Ssction 6321 t und that ths lien for wd+ toxss nnd ~ ,7 ~
qatvtory additions hos thsroby be~n rol~as~d. ih~ proper officer in the offics wtw:e not~ce of ~ ,-f ~f
internol nv~» tox Use wos filed o~ 14th , 19
~ is hereby n~ ~ •T 1~~ ~
a~thorizsd to rnoke noroNon on his books to ~how ths release of said lian, insofor as ths li~n ~ c~ ~p ~
rolotes b th~ followirg toxea. tj1 ~r CIt n'
J -J ~ A
NAME OF TAXPAY6t ~ C
o O
A~ ~ j~1C.~ ~ .
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RE51DBdCE OR RAtf OF dt151N6SS y p~
L~. ~ D~t ~ c~ v. 0? :
~a. 1~1s. a o ~ `
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CLA~ aF T/1X IJNPAID ML/1NCE
(imc IONurn Fwm P1o.1 PBtlOD B~n~ ~~SSE55MB~I! QA7'E IDENiiFlflNG NUMBER OF ASSESSIVAB~R i
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I i01~0 1'-~1~iS Oi•0~-ii 1~i-11-~1~ t,06Z.~
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P!/~CE Of HUNG
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WITNESS my hand at Jacksonvilla, Florida , on this,
thR 26xh ~of Nweaber 19 68
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DISTRJ dR6C'I~OR OF IM9lMAL RQVB~NIE BY (Si~rwtuh) T~TLE -
C'hief
A. J. 0'Dcanall, Jr. Spsciil Proc~durss Sect.
QrdTb GrMfloo» of of8a~r w/F~orizd by law ro tab b not ~nttal to th~ wl i ~a~f a.CM 26119. C.O.
1950-1. 126.) ~ ~K~~4 ~A(;E ~1~
PART 3-To b~ us~d for ncording purpos~s ,
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