The URL can be used to link to this page

Home My WebLink About1687 _ _ . _ ~ _ . . _ _ . . . Ifi . _ , - I Fw~ ~a U. S. 7REASlJRY DEPARTMENT - INTERNAL REvENUE SERYKE For Q~r,o.N! Us~ 8~ R~tadwy ON~ce ,(REV. 8~67) CERTiFiCATE OF LEASE Oi ifDERAI TAX~3IEN i DISTRI~T SERIAL ii0. 19~77-~' • . I ~ ~r a1 s~ I ~ Mr~by c~rti Jr thot os to tM (ol~owioq-AO~ -pxpay~~ th~ nquir~m~pts of S~eriw~ , , 63=5(a), _~iflftnel Rfr~nw Cod~, hov~ b~~n sq~i~fi~d>vnitl~ r~spect to 1M tox~s en~ - ~ 1 ~ e~lat~d I~w, toy~~Mr with oU stotwaY od~i~~oo~ po~cd•d br Section 63Z1; o~ ~ 1 ~ th~t ~tM ~n for sueh 1ox~s ond statut~K:oddit~ipns Ma therebr b~tn i~i~as~d. TI~ ; ~ propK oMfc~r in tl+e ofiiu whtn notic~ t~n~~nw{ hv~nw rox li~e wos fil~d oi~ ~ , s,~~~ ~ , i~'Jf Mr•br outl+w~s.d ~o nwk• noro~~~i ~ G~y~ on, bis books te ~6ow tM ~~bos~ oi sald lii'~i', insofsr as th~ li~n ~~lot~s to tfii ~~J,t V I ~ foNowiep-~ex~s. - _ ' NAME ~F TA PAYER " ~ . ~ ~ - y~+ ~ ~~1''~` ~r ~-0 - : , : ~ R SIDENCE ~ ~ • - _ ~ ~~f . , . I i _ _ ~ i ; C4~15S OF TA~X ~ = - ~ ;UNPAID BALANCE ~ (Tes R~twn ferrw No.) PERIOD ENDE~ ASSESSMENT ~ATE IDEP.TIFYING NUMBEft- OF ASS:SSMENT ~ (a1 . (~3 (d) , . j fii ~ 6-~-7~0 !'i~-~0 ~II~1~ ~ { ; - ~ ' ~ ~ - ~ ; ; ~ ; ~ ~ ~ - ~ ; - ; . ; i - ; PLACE OF FIUNG ~ . ~ ~ , TOTAL i~ . ~S I WITNESS my hand nt J~~M~~>~• t~n~ at this;. tfie_~~.dg? of ,19 70 . ~ SIGNATURE TITIE aaet O.ta.c cbi.t, sp.assl tros.+os.s at.t! MOTE: C«~siieon ~i.Htc•r o~.rlwi 6 Iw to tek~ xkn~wl~dy~~~ws is nor ~ss~nti~l ~o ~h~ v~li~iryr ~F NMie~ d F~~~1 Tea Liin G.CJil. 26r19, G.B. 195~51, itS.l e~~~ ~ ~ART 3-Te bi us~d for ncord{n~ purposts , ~ ~ ° ~ ~ : - - - _ _ ~ v~ . - -~•~~r~~~ . - .