HomeMy WebLinkAbout2328 i . . _ _ . .
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~d U. S. TREASURY DEPARTMENT - INTERtuI REvE?tuE SERv~CE Fa Op~ood lJs~ er R«ad.? r ON~
, ra~v. a.s~a CERTIFlCATE OF REIEASE OF FEpERAI TAX tffN
t ~ISTRICT SERIAI NO.
Jacksonvill~, Florida Z9039 8-71 P•266 -
1 h~rtbr e~rtify tFwt os to the (ollowiny-nom~d bxpor~r th~ rpu'usm~ots of S~etioil i~~
i 6325(a), Int~rool R~vsnw Code, hov~ b~M sotitfi~d with r~spect to tM tos~s enu-
mKOted b~lcw, toy~ther with ell stotutwy adiitfons orovided by S~ction 6321; oqd
I thot the li~n for svch tox~s ond stotutory oddit~ons las tMreby b~en r~leas~d. TM
p~op~r offifer tht,g[fic~ wh~r~ notic~ p~ int~rool r~v~nw tox li~n wos fil~d on
~ $d~L~~r ~O , 19 i• henbr ou~ho•~:•d to nak. oorotion '
; on his books to ~how th~ ~~leose of soid li~n, insofor os tM (i~n ~ebt~s to th~
i followinq toxts.
NAME OF TAXPAYER
Grover C b Lucill• ?hasas
RESIOENCE . -
~ Boute 3 Box 31S Fort Pierce Flo
I CLASS OF TAX UNPA10 3ALANCE
i (Tax R~tvrn Form No.) PERIOD ENDED ASSESSME'~!T DATE IDENTI~YING NUMBER OF ASS::SSMENT
~ (o~ ~bl • (c2 (d) (a)
,f .
~ 1040'Inco~e 12•31-62 5-3-63 266-01•9201 S 391.21 ~
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Fl~p Np ~~~1~~0~
ST. LUC!
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aFCO o vERIFlED~.
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~ 1 PM ~~22~
. -~~`-°C
~ C~FRK ~ FOITRAS
~ CI CUIT Cp(~T~ .
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! PLACE OF FILING C1lrk~ CilCUit Court
i
~ sc. wci. covAc~ TOTAL s
~ Port Piere~, llorida 391.21
~ i:-s.
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WITNESS n+r hmd at 3acksom?ill~. riorida , on d,;,,
10 ~ of Jnl~ ~ p 69
SIGNATURE TITLE ~
~ At Chi~f. S~ci~l Proc~dus~s Ssctioa ~
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MOTE: Cw~ilie~N ~1(is~. w~hri:~ Iw Kknwlsi~w~A• .s ro+ ~ss~m~si eM .o!.~~~y ~i NM~c~ ~ f.ia~l Trr l~a+G.1~11. ;
k11~, C.~. 11~51. 1=5.1 $
IART 4-T~ b~ AMiw~d b~? SK
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