HomeMy WebLinkAbout0224 1" ,
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i h~ aJ~ . U. S.. TRE~SIJI~ DE~ARTIWEM . uneew?~ REVEwuE sEeviCE ~ w or+i.w 1~. ~r ~••~y ana
j (REV. 1•b61 ~i~~~~ OF wLLiA~7G Vf T~
i aSTR~R SERIK t~MBER
Ja~loi~ll]~ 174154 B•175 p-1377
' 1 h~r~by aatify that os to tM followinp-ran+d t~a~PoY+r ths .equ~?«r,ants of Swion 63251a1.
In»rnol R~v+nue Cod~, hove been satisfied with ?~spsct b ths tanes enunwrated below, tope~ha
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~ with ull stotutory odditior?s provid~d by S~ctio~ 6321; ond thot th~ lisn for wch Mxss ond
stotueory additions has th~reby bw~ nleased. Th~ p.opK officK in th~ offio~ wf~w~ nonce of
in~r~ol r~,ue rox ~ie~, w„ fi~.d ~r, Januar~? 27th ~9~ is he,.b~, .
i outF+wibd to molu nowtion on his books w thow tlw nleos~ of ~ li~n. insofar w tM li~n
~ nlohs to tM fdiowin~ tox~s. ~
I NAME Of TAXPAY6t
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~ RB51DBdCE OR Pl/1~t.'E OF bUSINE55 `L
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CiASS Of TAX iMJ1iD BAIANCF i
f 1 ITmc WMn Fortn No.) PERIOD ENOfD /tiS5B5AABQT QA~ IOEMIFYING Wl)MBER OF /\56E55AlIB~lr
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FI D AND RECORDED
s ; ST. UCIE COUNTY. FLA.
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; .oc1~~ :-~ti Ras
' CL RK CIRCUIT COURT~
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WITNESS my hand at Jacksonvi l le, Florida on this,
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~e 1T th day of Aari l ,19~
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Jack rant Chief, Special Procedurea Staff
~NOtTE: GrtiFimt~ of offiar ovMwrized by law ro rob odcnawl~dynrMS h na~ ~ssentid to wlid~ty of this doaw~wn~. G.CM. 26119, C.l.
s_~j tsso-t, t2s.~ ~d00K~04 P11CE z~4 Pb
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rs PART 3-To b~ used for r~cording purposes._
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