HomeMy WebLinkAbout1506 . ' - ' ~ ' ~ ` -
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po~ ~a " U. 5. TREASURY DEPARTMENT - u+Tearu?~ REVEHUE SERV~CE Fa qw~a+ol Us~ B~ Recordrg OH~c~
~REV. 8-67) CERTIFICATE OF REtEASE Oi FEDERAI TAX LIEN FILCD t.~t0 R~CORD~D
DISTRICT SERIAI N0. iSl~l ' ..'=.~~UC~~ ~Ol~":TY. F!
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1 hereby c~rti(y thot os to the (ollowing-nam~d-toxporer the ~equirements of Sectio~ ~Q~~ry
6325(e), (nt~rnol Rtvenue Code, hove bean satisfied with respect to the toxts enu- 0 ~
merotsd below, together with oll statutory odditions provided by Section 6321; ond s'~ /Z !;'F Z;~ ss
thot the lien fw such to:es and stotutory edditio~s hos thereby be~~ r~leos~d. Ti~e ~ Jj ~
proper officer in the offics whers notice of internol rerenue toz lien was fil~d on :
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tulv 24 , 19
69_ ~s haroby outhorized to moke nototion ; L;~Tn;~ti
~ on his books to show the releose of said li~n, insofor os the lien r~lotes to ths Ci.~ ;+~E;: j~t~; ~pURT
followinq tozes. J
N4ME OF TI~XPAYER
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RESIDENCE
~j11 ~MOL~OD~~ ~Oa~~ !~'t M~l~M~ ~ii~ • j~ •
CLASS OF TAX ' UNPAID BALANCE
(Tax Return Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(a) ib) ~c) ~d) ~e~
9b1 1R•j3~-6~ 1r~1rb+9 ~9~-A9~67~ 390•TT
i ~y,t }~3,.6+! T•Jr6+! 59~•o9'76T4~ 6~,.oi
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~ ~ LaCE OF FILING C~~~ Q~it
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~ WITNESS my hond at Jacl~~nvilla, Florida , on this,.
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; the 218t doy of Januatv ,19 70
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SIGNATURE • TfTLE
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's~~~~, (NOTE: GrtiFieoq oF o(Fie~r authori:~d br low ro toke ockno..ledQen~ms is oof ~ss~ntiol to tM vo{i ~~y of Na~e• ot F•d•rol o: Li~n .C.M.
26419, C.B. 195o-5t, 125.)
~ooK 182 1504
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PART 3-To be us~d for recording purposes -
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