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HomeMy WebLinkAbout1686 _ . . ~ ~ _:.-~--ts.+..~ :±~.u~a+.cr.'t - r -s-~!'r^-+'~' _ - . ' . . - . _ r . ~''N ~.F- _ . ~ _ . ~ _ : . - , . . ~ . 4...5~ n. , . . _ . , . . . ' ~ ' ~ ~ U. S TR ASURY OEPARTMENT • a+TERN+?~ REveNUE sERV~ce Fw «adr~ OHT ~ F~~w 668 ~ - tREY. 8~671 CERIIFICATE Of REIEASE OF ffQERAI TAXr~lEN ~ Y . ' DISTRICT - • ' SERUL NO. ~ _ ~ • - ~ _ . ~ - 9 9 +21 1. er~by c~Nify tiwt os ro the Foliowiny-ewm~Zjoxpo~r~r th~ r~quirsm~nu o! S~ctiM 6325(0), Internol R~v~~ue Cod~, how b~M seti~li~d with r~sp~ct to ~ tox~s enY~' ~ - m~tot~d ~1~.+, to9~tMr witA oH stotvtorjr od~i~ions povid~d br S~etion 63~1; or.td : ~;Y. . tl+at tM ]',i~n fo. sueh ~o:~s and stvtutory odditiens I+os +h?r•br b.e~ ~I~os~rd. Tl~it proptr offic~r in tM oHic~ wbth eotic• of iihtimol_.tiwnw tox liee :~ros fibd ~Il ~y'~ '?lit . 1 ~ h...by out6w~:~d ro nwk. noat~~n ~e ~ on` hi~~baoks to #I~ow tM r~l~os• of soid 1~, in~tofor os ~M li~e r~lot~s to tli~ - . ~ foi~~,~~.,ax.:-: ' - . v_ ~ NAME Of Tll PAYER ~ ~ >J . •_r ~ ~~a ~ - ~ RESID~NCE - ' _ • ' : ; . ` ti~ ~ ~ ~j ~r~ . ~ j CLASS OF TAX UN~AID•BA~,/1NCE ~ (Tox R~tu?n Forni No.) PERIOD ENDEO ASSESSMENT DATE ~ f-- IDENTIRYING,NUMBER OF AS~ES'SMENT ~ ~o) ~b) (cl (d1 - i I~ ~ i ii i ~ ~ ~ 1 f } ~ . . ~ ' i ~ • - ~ i ~ ~ 1 - I ' 1 ' ~ . i ~ ~ 7 I i I ~ I ~ - ~ I ~ PLACE OF FIUNG ~ ; ~ TOTAL , f i i I ~ i W17NESS my hand at .?aelc~env 11~~ Flerida , on this,: ths 27th doy of 1tev~ar ,19 70 , SIGNATURE TITLE ~ J Chi~t- Sp~cial Proc~dur~a Staff MOTE: Catifieoa of fie• wtiwri:~d by I~w ~o tok~ ac4newl~dyw~irs is net ~~s~m~sl te ~M validiry ~i NWic~ 01 F~1~r~! Ta: Li~n G.CJ~I. 26t19, C.B. 19SOS1. . s~k PART 3-Te b~ us~d for ntoaHry-purpas~s . - _ - ~:..L- w ' ~ . . . ~:h Y - ~~~~~'~'C'n' f ~x.~ _