HomeMy WebLinkAbout2552 . - - . . . . . . . . _ • J ~`r~ . . _
fom+ 668 DEMRTr.~ENT Of 7HE TlEASt1R~l-iYTfW/1l I~vENUE SEMCE For Oprcnol U~t ~ R~cwdng OIFca
;~v ~.~o~ CBtT1ACAIE Of RELFASE OF iEDQAI TAX UEN ~~EO ~~eo ~Ea~
D~STRfCT ~ SERIAL NUMBER s.~daE couM
i~Mn~s+di.L~~ Yl~el+i~ c~E~c Rcui
~T
I hereby certify that os b the following-narned taxpaper the requiremenh of Section REOORO YERlfiE~
6325(ay, Internal Rev~enue Code, have been sotisfied with respect ro tfie taxes env-
mcrated below, together with oll statutory additions provided by Section 6321; and li i' AM ~1'
tiwt the lien for suth roxes ond stabtory additions hos Ntereby be~n releosed. The
pcoper oH'icer in the o11'ice where notice of inlerr?~ revenue tox lien was filed a?
N0~91~@t 20~ • , 1QQ_, is lxreb~r oufhorized fo nloke notation ~94'7
on his books to show the relaase of soid lien, insofor as the iien retates to the folbw-
ing taxes.
NAME OF TAXP/1YER r1~0 ~
RESIDENCE
~~~a~~
UNP/11D BALANCE
KIND OF TAX T/1X PERI00 ENDE~ ASSESSMENT DATE IDENTIFYING NUNI6ER Of ASSESSMENT
~ ca~ ro~ <<~ ~d~ i~~
~
;
~
E ~ i.~o.7~t l-sS-1o !M-~loop ~.~i .
s
;
~
~
~
_
k
s
~
~
~
~
~
~
G:
j
~
PIACE OF FIUIVG
_ ~ ~ O~ TOTAL ;
nQ~M~
dJ1TNE$S my hond at Jacksonville, F1oMda , o~ ~,~s,
~
~
- .~,e 13;h dar of Ap~l , 1971
~
~GNATURE TITtE
~
_ Jack Dnran+ Sr~ciai Prc,enc~u~s St~Ff
(NpTE: Catdicole of o ed by iow to toke ocknowtaigmenrs ~s nor estien+~o! 10 1he vohdy ot Nohce of F~ol Tox l~en G C.M
261~9, C.B. 1950-Si, 25.
~ ~ ~.~i ss
" PART 3-To b~ us~d for ncordin~ purpos~s
~v
4 :
_ . - -
. _ _ _ . _ ~