HomeMy WebLinkAbout1361 . • . ~ _ e t . - • . . _ ,
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' F~ren 664 U~S. TREAJUKY
D~TMENT - INiERtiA~ REVENUE SERVICE 1 ~ F« Op.aw1 Us~ By Recard~sy Or~~ce
' '~REV. &67~ CERTIFICATE O~ RELEASE OF E~DEqAI TAX ~tIEN ~~E~~
~ DISTRiCT SERUL NO. _ iL~
C~
alEltr ~IRCWT ONMT
( he~eby c~rtiir tho os to Ihe foilowin9-nam toxpoyer the reQuiram~nts of Section ~*,QR~ YERifI~~
63YS(a), Int~rnal Revenu+ Cod~, hove be~n satisfi~d w~tF respect to the tox~s cnu-
m~rot~d b~lo+v, toQ~th~~ with ali stotutwr odditior+s prov~ded by Section 6321; ond ~ ~Z ~ l+~~~'
thot the lie•~ ~o~ such tozes ond stotutory additi~ns hos tfie~eby beeo r~l~os~d. Ths
; p~op~r o1licer in the offic~ wher~ notice of inhrnal rovenu~ tax lien wos filed on
_Au~~yst 21~ , 19 TQ is hereby authori:~d to nwk~ nototion .
on his books to show the r~lwse of said li~n, inso(o~ os th~ li~n ~elotes to th~
iollowinq Mx~s. -
NAME OF TAXPAYER ~
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RESIDENCE .
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Het lLr~ l7~r
CLASS OF TAX UNPA10 BALANCE
, (Tox R~turn Fwm No.) PERIOD ENDED ASSESSMENT DATE ID~ ;•TIFVING NUMBER OF ASS:SSMENT
(01 (b) (~l (d)
9ii 3-~-~e 7-~,a.7~o ~ 59~-s~ 1691.~
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~ ~LACE OF FILING ~
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~ N+~TNESS my hand ot Jacluoavill~, llorida on rh~:,
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~ ~he 7th dQy of Jaauar ,1971. _
~ SIGNATURE TITLE
JAt~ Di~1~? ~..~~i. $pscial Proc~duras Staff__
•'NO~E: C~.r~fico~~ oi eE~ic~r ou~ho~i or o toce ockno..bAym~nts ~s no+ ~ss~nf,o{ to tM ~ol+e~er ot Na~w d F•d•rot Tu Li er G.C.M.
26119, C.B. 195051, 125.) ~ eb
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PART ~To b~ us~d for r~cordin9 purpos~s
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