HomeMy WebLinkAbout0437 , -
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~ ~ Fo.m bbb U. S TREASURY DEPARTMENT • IN7EaNA~ aEvENi)E sERVICE Fu Cv~ ~'ol Usc Br Recri~~g 01t~cc
~ REV. 8-57? CERTIFICATE Of RELEASE Of ffDERAI TAX UEN ~ !
~ISTRtCT sERiP~ No. 184110^ F~LEO AND REC4RQED.~
ST. L.UCIE COUN'rY. F~A.
OR 1 Pa e 1083 RE CORO bERIFIED
1 ereby certiiy thot os to the iollowing-named taxpayer the requiremants o( Section 1858J`~
6325(0), (nternal Reve~ue Code, have been sotisfisd witF~ respect to ~he toxes enu-
meroted belc+~, togethe. w~th o!1 storu~ory additions p~ov~ded by Section 6321; ond 1~ `9 ~ ~ ZZ
thot the lie•~ for sucF+ taxes ond stotutay odditians hps thereby bee~ rsleased. Th~ ~
proper ofFicer in the oFfice +~here nor~ce of internol revenue tox lien wos filed on ~L
; „Qrtnhar 9 , 19~1Q._, is he?eby outhor~zed to moke norotion
on his books to show the releose of soid lien, insofar as the lien relutes to the RO~ER PO~TRAS
; foiiow;,,9 ,,Xes. C~ERK CIRCUIT COURT:
NAME OF TAXPAYER
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! RESIDENCE
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li+te~+ia
~ CLASS OF TAX + UNPAID BALANCE
'Tox Return Form No.) PERIOD ENDED ASSESSMENT DATE PDENTIFYING NUMBER OF ASSESSMENT
(o ) ~d ) (c ) (d ) ~e )
3~o1rQ ~/~/6T 11/~,/~ a ~,~l9•~
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P_ACE OF FILING
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~ ITNESS my hand at Jacksonville, Flo]cid8 on th~s,
rhe 14th doy of t'~o'~?embe~c ,19 69.
SiC,NATURE TITLE
c rant Chief, Special Procedures Section
~PJ07E: Cerfific re o(f;cer aurF,arized br low ro toke ocknowtedqmenrs is not essentiol to rhe validiry of Notice oF Federel TeR Lie~ G.C.M.
~ 25119. C.B. 19 . 125.1 ~ ~~y~
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~ PART ~To be used for reconling purposes ~ " - - - - -
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