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_ , ' ' U. 'S.` TIEE~?SURY OEPARTMH~IT = ~1itRw?L REVNiYE ~E4vICE
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~ `~REV-r,ov. ivsi~ CERTI~ICAT~ OF RELEASE OF F~ERAL TAX, -
I (FomwAy Fon* 669~ R~ M w~d 1s MI~N To= U~ws nnd~[ i~c1Mn i~25(y,1.LG ~f 1~i4 '
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I I hereby certjfy that as to the following-named taxpayer the requirennents of Section 6325fb), Infernal
~ Revertue Code of 1954, have been safisfied with respect to the taxes enurr~rated below, togethe~ with
` all stafutory additions provided by Section d321; and thut the lien for such toxes and sMhrtoni additions '
f has the~eby been released. The proper ofRcer in the office where notice of internal revenue iax lien
~ wos filed on ~uly lSth , ~ q63 ~~S ~~y ~~rized to make ~otation on his books to show
i the release of suid lien, insofar as the lien reiotes to the foltowing taxes.
r W1ME Of TAXPAYER. -
RE,51DB+1CE OR Pl/1CE B1161NE95
~ TYPE OF TAlC M1D PERI00 ASSESbMENT DJ1TE NO. AMOUNf OP
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~ ~ ~IACE OF fItING ~
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TOTA1 =
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~ Jacksonvill~, Florida ,
WITNESS my hand ot . ~ ~~s.
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~ 9th f April 19 6a ~
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~ A. J. O~Bonn~ll, Jr. Chi~f
Special Proc~dur~s S~ct.
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~ {NOT6 autA~~w N tob - b nor ~ss~ntbl b th~ volidib ~f d~ ~aiw~M. G.C.M. Z1~1 C~. 1950-1, 145.)
~ TAgT 3 To b~ vs~d for neordln~ p~erpos~s
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