HomeMy WebLinkAbout2057 ~ U. S TRfASURY DEPARTMETJT • INiERNAI REVENUE SfRVIGE hr 01~Ihwd M/P M~wiiy d11w
(REV. 1-66) CERTIFICAfE OF RElEASE OF FEDERAL TAX LIEN ~~p ANO ~~oEOj
n~srR~a ' SERIAL NUMBER • T. IUCIE COUNTY. ~~A•
~'~~Li ~ 176d54 B176 P 149 _ Rf.COR~ V~RIF~E~ ~
1 h~r~by d.tify that os w th~ following-~om~d to~cpay~r N+c requ~remenh of S~ctan 6325(al. 1~~
Inqrnol Revenue Code, how been sotiified with nspect to the to:es enume?ated below. togethsr p~
w~th ai) statutory odditio~s Prcvid~d by Ssction 6321; ond that the lian fa uxh toxes on~~ Of~T 'S fl'7
stotutory oddit~ores hos thsreby bw1 released. Th~ pro?~~ officer in the office wMn not~cs of l~
int~rnol rtv~nue ?ox (iM r+ros filed ori ~~h 25 ~ , 19 69 , is hemby ~
autFwriztd to moks ~ofatio~ on his books b slaw iM releose of said lien, insofor as tfie lisn ~pGER POIT AS
«~or~ b tM folbwiny taxes. (~,LERK CIRCUIT COURT•
P1AME OF TNCPAYER
~ ~ ~
RA1oa~~
OR PtACE OF BUSINESS
]b1D '~"a ~~t A~e~~j~~
aA55 OF TAX UNPAID dN.ANCE
(Tmc Wtwn Fom~ NoJ PERIOD ENOED ASSE'S51111BdT DATE IDEMIFYINCa NUMBER OF /155BSMBd~
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y ~ ~I ~S~j TOTAL = 1~~
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~ WITNESS my hond at .ta~kAonYill~-~F~ ^r; ~a on this,
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~ the ~h day of ~teber , 19~~
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~ SIGNATURE TITLE
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; (NO~TE: Gnifimt~ oF ouNwrized by low ro tnk~ oclcnowledgmenh i~ not tssential to ths val~d~ ~ t~ nt. C 19, C.l.
~ 1950-1. 125.)
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~ PART 3--To b~ vs~d for recording purposes . S
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