HomeMy WebLinkAbout0743 ~ ~ 7 3'7 ~
Forn~ 668 U. S. TREASURY DEPARTI~IENT - ~H~ rRH~~ aevEKUE SERVtCE Fo. po~~onol Us~ Br Recad•~.q Oli~~e
R E V. 8•67) _ CERTIfiCATE Oi RELEASE Of iEDERAI TAX IiEN
DISTRICT ' SERIAL NO. ' FIlEO RNO NECQRQ~~
zY. ~uciE cou~~~ ~
Jacksonville Florida 1 61 6 Bl P2611 aoCER PoitRUs ~
1 he~eby c~rtify that os to the Following-nam~d toxpoy~r th• requi?em~~ts of S~c?io~? CIER~~~Rf1ED~
6325(0), Internol Revenu~ Code, have M~n sotisfied with respect to thE tox~s env- ECQRD E
meroted b~lo«, together with olt stotutwr odditions provided by S~ction 6321: a~d PM'~*
thot the ~ien fw s~ch toxes ond stotuto?y additions has thereby been r~l~osed. Th~ ~6
proper offiee~ in th~ office wher~ notice of int~r~+ol revenu~_ tox lien wos filed a+
Ju~,~ 17~. , 19
7Q
- is heroby authorized to moke nototion
on his books to show ths release of soid litn, insofar as the lien r~lotes to the
followiny faxes_
r:AME OF TAXPAYER
~ E SIDENCE
1102 Trir~idai Avenue .
CLASS OF TAX UNPAID BAIANCE
~ ux Return Fo~m No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(c ) (b ) (c ) (d ) (e )
lOLo 12-31-68 6-6-69 239-40-8882 147.88
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~ Clerk, Circuit Court TOTAL s l1i7.88
' St. Lncie Caunty
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- ~ TN ESS my hand at JBCksonville ~ Flol'ids , on th~ s,
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~~.ATURE TITLE
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, ~NOTE: C~r ico~~ ol o~licer o~~hor~i~d by law ~o ~oke ockno..ladym~nts is not ~ss~nt.al ro~he vol~d~ry of No~~c• ol Fed~rol T~¦ ~un G.C.M.
;.g ~9l19, C. . 195451. 1Y5.)
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~ PART 3--To be ussd fo~T~~a~pu~poses~~
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