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HomeMy WebLinkAbout0191 ~ ~ ' ~ - ~ • ' ` ~ . . _ - _ - ; f~?~ 663. U. 5 TREASURY ~EPARTMENT - InTERHA~ REvEM1E SERVKE Fw p~,mo1 U~e Br Rece.drq OH~c. ; (REV. &671 CERTIi1CATE OF REIEASE Oi FEDERAI TAx UEN t o ~ e~ . I OISZRI T SERUL NO. " ; ~ . It fN O.lt, ~A'2 1t71 O~t ~C~ f~ . i 1 h~r~by c•.~ifr •hot os ro ti,• follow,ng-nom~d toxpoy~r th~ r~Quirsm~nfs ol S~ction ~ 6325(0), Int~rnot R~wnw Cod~, hove b~~n sotisfied witl• r~spect to tl~e tox~s enu- ~r I nNSOt~d b~lcw, to9eth~r wifl~ all stotutory odditiona provid~d by S~ction 6321; ond , I ' thot tl~~ (i~n fot such toaes ond stotutwy additions hos th~r~by bee~ r~l~os~d. Tht ~ p?op~r ofiie~r in th~ ofiice whe~~ notic• of int~rnol n~enw tox lien was fil~d on . J~~ ` , 19 70 is b~reby outhwii~d to mak~ norotion ` oe his books to sbow th~ rel~ose of said li~e, insofar as tF~e li~n nbtts to fA~ nr VL/ feltowin~ fa=~s. ~ NAME OF TAXPAYER ' ' ; - ~ RESIDENCE ~ ~ ~ ~L ~Mt • . ' CV?SS OF TAX ~ UNPAID BALANCE I lTox R~twe Fam No.) PERIOD ENDED ASSESSMENT OATE IOENTIFYING' NUMBER OF ASSESSMENT (o) (b) (c ) (d 1 (e) i - ~ ~ ~ . i ~ ~ ! { . . i ' f ~ . . i ~ PLACE OF FIIING ~ ~ TOTAL f ~7~~ ~ ~ *~S~ ~ ~ ~ ~ ~ ~ WITNESS mn c~nd ot JaCksq~1/i11~~ Fl+Olid~ , on this . • , tfie SOtble;~ of Octob~!' ,1970 ; ~ - ` ~ ~ ~ SIGNATURE - TITIE # ~s~~ dt1~, 8p~cial ts~oc~du:w ~ (NOTE: C~tific~N el eilic~? evt i d'o lav to tok~ xkne..l~ j r dy~~n~s i~ net ~ss~Miol to tM .el+di~r .f N.~ic• e1 F.A..ot T.a li~n G.CJN. - 26r19, C.8.-19SOS1, 125.) ~ ~ i~i ~ ~ART 3~-To b~ us~d for ncadin~ purposss ~ s~ - _ - ~ ~ ~ _ . ~ r