HomeMy WebLinkAbout1451 I - - - ~ t ~ - - ~e~'--..a~~~ii~v_ - . :'"-~'.'C~';': - . • . i. . -e
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' ~ U. S. TREASUR,Y DEP - INTERNAL REYENUE SERVICE~ ` _ ~F~raliwlUs~a~ONln
(REV. s.e» CERTIFKATE OF ~IEASE Oi F~ERA! TAx LIEM--, .
DISTRICT ' SERIAt~-NO. ~ F~~~ AND _
17oT19 ' .$T. ~~CIE C0~1~~R0
~ ~ 3 P 20fi0 ; q .CORD V~ . ~CA.
I Mr~ y eertit~r thot os to th~ foilowin9-nanwd tex P`~`~r tM rpulr~nwnts of S~ctioe _ ~,~~E~
63?~(0), (nt~mel R~v~nw Cod~, hov~ b~o sotiafiid`~rith ~~sp~et to th~ tox~s ~eu- 4
~ m~ro»d b~lo+k,:toy~th~? with oU stotutory odditions-povid~d bp S~etion 63Z1; ond u ~
thot th~ Ii~n fw such fox~s o~+d stowtoryr oddition~ Ms th~r~by b~~n r~l~os~d. TM JAA ZT 3 i" yt
~ {xop~r offic~r ~n t1w offic~ wh~n notice of int~r~1'nv~nu~ to: li~n wos fil~d on ~
' S~teIDbe~T` 2~ . . 1Q_(~~ is Mr•br ou~h«i:.d w nak• now~ion
I on his books-to show tM nl~os• of said (i~n, ieaofor os tM li~n nbt~s to /M RO^v R ITRAS
~ Fonow~~q tox.s: CIERK CIf~CU1T COURT
~ NAME OF TAXPAY~R -
~ s~.~r a.s1.r? .
~ RESIDENCE
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CLASS OF TAX UNPAID BALANCE
(Tox R~turn Forw No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSAIENT
(o) ~b) (c) (d)
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PLACE OF FlLING
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~ r , , ~ TOTAL S _
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WITNESS my hand m -Taa~c~nvi~io--~s~#~1 , an this,
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tfie_1'~3,h_doy of .T~ya~_,19 /~n ~
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SIGNATURE TITI.E
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Chie~~ Special °rocedurea Section `
(NOTE: IcN~ d efftc~r wtiwtsed br law te ta4~ ockno.rl~w~n~s is net ~ss~Miol te tM veli~rRf F~ Y ~ .C~A. ~
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