HomeMy WebLinkAbout1507 ' - ~ ~ _ ~ - - - . _ . . ,
p~ U. S. TREASURY DEPARTMENT - tNTEaN~~ eevENUE SERV~tE Fw QN~owel Use B~ Reco.d.y O;~~cs
(REV. &67) CERTIFICATE OF REIEASE ~ FEDERAt TAX UEN FILED AND RECORDED
OtSTRICT SERIAL NO.
ST, IUCIE C~UPITY~F
OR 178 Page 2614 ;;f lA.
C(`~n ;~~r;~_.-Q
1 her~by t~rti(y thot os to the (ollowing-named taxpoyer the requirements of Section ~ Q~
6325(0), Internol Ravenu~ Code, have been setisfied wifh respect to ti~e toxss enu- 0 ~8
merot~d bslew, tog~ther with all stotutwy qdditions provi ded by Section 6 3 21; en d 27 PM
that th• lien (or such taxes ond stotutory oddi+,ans hos thereby been relaosed. The ~'j~~~1 2; 56
prop~r officer the office where notice internol revenue tox lien was filed on ~
Jui9 ~2 , 19
~ is hereby outhorized to make nototio~
on his books to show the releose of said lien, insofor as the lien relotes to the ~1~=-:=~: ~Ot7~,F?,,~S
Follow~~y taxes. ~LERK CIRCUIT COURT
NAME OF TAXPAYER
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aw~zs~ s~t
RESIDENCE
. ~ o ~ax ~s
: ClASS OF TAX UNPAID BALANCE
(Tax Return Form No.) PERIOD ENUED ~"SESSMENT DATE tG 'IFYING NUMBER OF ASSE~SMENT
i (o) (b) Ic) (d) (e)
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I 7~M ~~'M ~ ~/i7 ~1~/~~ ~Z.~
j 7~wr ~l~~w ~~~+~~75
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~ PLACE OF FILING ~
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r l~ct Piai~N Tlo~'ida
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~ WITNESS my hand at JBCksonvilla, Florida , on rhis,.
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; 22ad d~, of January 19 70.
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~ SIGNATURE ' TITLE
~1 U iy1
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~ V. li. Levis Acting Chiaf, Special Yrocedures Section '
(NOTE: C~rtifieat~ of offie~r outhori:~d br low to toke acknowl~dyen~ms is not ~aa~nt:ol to the volidity of NWic~ oF F~dsral Tox li~n G,CJiA,
~ 26119, C.B. 195451. 125.) p
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~ PART ~To ba used for recording purposes -
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