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fo~u~ 6b6 U. S TREASURY ~EPARTMENT - iwTERN~~ rtEvEMuE SERVtCE Fa OW~on~l Us~ B~ Recadry ON~ce
(REV. 8-67) CERTIFICAtE OF REIEASE Oi F~DERAt TAX~ tiEN .
DISTRICT SERIAL NO.
~ .Jackaonvill~ FILEO ANO RECORDED
T. LUCIE COUNTY. FLA.
( 1~etebr certify tl~at os to the (oliowing-nam~d.ioxpoy~r tl~* r~auirsm~MS ol S~ction fi~ COR~] ~/~{~'~',~~Q
632S(a), (nt~rnol Rev~n~t Cod~, l+ovs be~n satisii~d with respect to tA~ tox~s enu- . 1Q Q
merot~d b~ic«, to~the• with ot) stotuto?r odditions provid~d by S~etion 6321; and v
thot ths.lie.+ for such toxes ond storotory odditions hos •M~:br be.n nl~as~d. The O~I ,e p11 q: 33
prop~r officer in the ofiite wher~ notics oE internal r~ve~w tox litn wos filfd bf~ 7 rr~ ~
l~mrrb~r 3rd , 1q~~" is Asnby outhoriz~d to moke nototian ~
on his books to shaw the r~leose of said li~n, insefor os th~ li~n r~btes to fhi
followin~ tax~:. s2QGER POITRAS ~
~AME OF TAXPAYER CI.ERK CIRCUIT COUR7.
Ed. 3. Cha~t~s
RESIDENCE ~ro~ Pi~scs, Florida
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1 ClASS OF TAX - UNPAID BAI.ANCE
(Tox R~twn Fwm No.l PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(a ~ ~ ~bI ~c 1 (d ) (e)
I' 943 12 31 /65 8 18 6T -
~ ~ / / / 5964321130000 7 164.31
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! PLACE OF FILING
~ j C1~rk, Circuit Court
I St. Lucis County ,TOTAL s 1b4.31
i Fort pi~rce, Florida
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WITNESS my hand w Jackaonvill~, Florida , a,
the Zttd of Octoh~t ~q 69 -
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SIGN T E TITLE
J Du t Chi~f, S ial Proc~dur~s 8~ction
MOTE: C~rtlfieea of of/icer outhari:~d by Imv ro tok~ xk~owl~dy~n~s is not ~ss~Miol te ~~~tr ef Ndie~ o( F~d~ra! Twc Li~n G.CaI. .
~b119, C.B. 195051, 125.) ~
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PART 3-To b~ uud for ncordl~q purpos~s
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