HomeMy WebLinkAbout0048 ~C s-icyy
Fen~ 648 U. S. TREASURY DEPARTMENT - ~NTeaN~~ rtEVeNUE SERV~CE w qw~ual Use Br Re2o.d~y Off~c•
(REV. &+57) CERTIFICATE Oi RELEASE OF FEDERAL TAX IIfM ~
DISTRICT SERIAL N0. jpt ~ ~
1 h~rebr c~rtify thot os to th~ (ollowin9-oamed toxpoy~r the requ'uem~nts of S~ction
6325(0), Int~rnol R~v~nw Cod~, hove be~n sotisfied w~th resp~c~ to the tax~s enu-
m~rated ~Iew, tog~ther with oll stotuto~r odditio~s p~ovid~d br Stction 6321; o~d
tlat th• lien for such taxes end stotutory odditions has th~reby been rtfeos~d. TM
p~op~r officer in the o(fict wh~re notic~ of intsrnol revenue tox (is~ wes fil~d ~ p g$ G 8
__~0~~2' 3~~ , 19~,_, is herebr outhori:ed to moke norotion
on his books to show the ~el~ose of said lien, insofar as the li~n r~lotes to th~
followin~ tox~s.
NAME OF TAXPAYER
JS~es M_ k Cl gra g AAa~'
RESIDENCE
171o South 28th Stt~eet
C1A55 OF TAX UNPAID BALANCE
(Tax R.rurn Fum No.) PERtOD ENDEO ASSESSMENT DATE tDENT1FYING NUMBER OF ASSESSMENT
Io ) (b ) (c ) fd ) (e )
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~ 10lt0 12-31-61t 6-9-65 ltl.li-51~-80l~9 12t~.33 ~ ~
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" ~LACE OF FILING
CIBI'1C~ Circnit Conrt TOTAL ' S 12(l.33
_ St. L~cie County
= Fnrt Ptetr_e _ Fl eri da
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WITNESS my hand at Jacksonville, FloMd~? , on this
R . .
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` e lb th d
oy of E~1sY'oh ,19~1
~ SIGNA7URE TITLE
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~ Jack Durant Chief ~ St~cial Pre~ nrB s,~~f~
; (NOTE: C~r~~ficoq o1 0~(' r u i d by Iow ?o to4• ockno«I~dqm~nts is not ~ss~nt~ol to rM .ol~d~ty o~ Not~c• 01 F~d~rol To, Li~n G.C.M.
~ ~~.~9, C.B. 195451. ~ aa
~y ~~~K ~.91 4~
~ PARY 3-To b~ us~d for recordiny purposes
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~ '~1911~'~ =
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