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HomeMy WebLinkAbout0171 ' / -z~._~t~ T • ~ _ - ~ •`~~~~`~a ll. S,: EAStiRY OEPARTMENT • ~Nt[~2?+~~• rtF~vENUE SERVICE Fe, pp.,a,.,~ u~~ er a«aa~ a~~« ~ IREV. 8-57) CER FICATE OF REIEASE Of iEDERAI TAX l1EN • s.~~~ Co tt ~ DISTRICT SERIAL NO. ^ OCER POIT~Af ' 188713 B-182 P-1230 CLE11K CIRCUIT COIM ! RECO~tO VEKIFIEO " he~eby c~nify thor os to the Foilow~ng•nam~d toapoyer the reQui~emtnt= of Section.. ; b325(a1, Int~rnoi R~venue Cods, ho~e be~n sotisfied witb ~espec* to the tox~s enu- 'O ~~~e m~~oted b~IcM, ro9sther w~tl, oll stotutay additions provided by Ssctia+ 6321; o~d thot the lien For such toxes ond stotuto?y odditiaes hos th~reby beeo r~leosfd. The peop~r offic~r in the ofiice whsre eotice of int~rnol revenw tox lien wos f;l~d on .T~nuaY•~3rd , ~9 7Q is her~by outho~ii~d to nwke noro~ioe 2~~~~ ' 3 , on his books to-show the releose of saed lien, insofor os the li~n rebtes to ths follaring tox~s. ~ NAME OF T~XPAYER ~ ~ l~tL Q~ti~ -i:L f~l~ ~ - RESIDENCE ~ . a~ ~l t~ ~+~l~~ CLASS OF TAX UNPAID BALANCE , (To: Reture Form No.) PERfOD ENDED ASSESSMENT DATE IDENTIFYfNG NUMBER OF ASSESSMENT , (o ) ~b) (c ) ~ (d ) . (e ) i = ~ ' ~ j ~ ~••~ti-~6~ 3t~it-6~ 59~ lS~~T~ ~ i ~ ~ ~ ~ ~ ~ PLACE OF FILING ~ ~lc, Cls~wit Qwss . ~ a~ i.~. cwa~ TOTAI : ~ - !ti. T3~s~s, ria~ ~ ~ ~ ~ ~ WI TN ESS my hand at .tan_ic~nvi l]~_ Pi~t.i da , on thi s, ~ ~ the 22nd day of Decem~r ,19 7A ~ S~~ ~ uNATURE TITLE ~ (NOTE: Cersificor~ o( oific~r o~~l+o?i:~d ow ~o toke ocknowbdpm~ms ~s r,o~ •ss.~rol ~o ~M .ol~d~~r of Na~u of F~derol To~ L~en G.CJrI. ~ 26119, C.B. 193P51, 125.) ~ Q ~ . s~~K ~89 p~Es~. 71 3 PART ~To b~ us~d for rscordinp purposas • ~ ; ~ ' ; ; , ~.3'' ~Is`_ ; ~ . _ w~ - ,,t. Y ~ ,1~`~ ~ ~s~.`-~_,,,,, . . s ~~~~~~.~~~s`-s"~.~ _i ~-zat_