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Fo?w- K8 U. S TREASURY DEPARTIAENT -~ntE asa _ RE vEkut Sf 4v~CE Fu ~~.o-,e1 t/s~ 8~ Rscvd.7 WL~.
:REV. 8-5%'. CERTiFICATE OF RELEASE OF ffDERAI TAX l1EN
D:STRICT ~ SERIAI NO. v g
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• t~~? ~$8501 8182 P963 aeet c~~rt araT
1 hereby certi(y thot os to the Following-nom~d loapoy~r the reQu:rem~~ts of Sec~~on ~R~~
6325(0), Int~rno) Revtnu~ Cod~, hove Mtn sotis(i~d w~th respecr to t!~t roxes c~v-
m~rated b~lc+~, rogether with oli stotutar cdditioe?s prov~dcd by Section 6321; ond
thot the lien Ior such ~ax~s ond stotutar oddi~ians hos the~eby bsen r~lecsed. The
proper officer i~ the o((ict wh~r~ notict oi internol :evenue to: lien wos f:led on
J~nua~y 19, ,~930 . is h~reby au~ho.~z~d to aak~ nota~ion
on his books to show the rel~ose o} soid li~n, inso(or os tFk li~n r~btes to the
followin9 toxes.
NAAtE OF TAXPAYER
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REStOENCE -
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C1A55 OF TAX U!lPAID BALANCE
Tox Rerurn Form No.) PERIOD ENDED ASSESSMENT OATE iDENTIFYtNG NUMBER OF ASS =SSMENT
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TNESS m~,and at Jacksonvi 21e Florida
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~ +ne 1*h day of PSaY ,19 71
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~ ~ ,;NATURE TITLE
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~ Jack Durant Ch ef S c a d
~ ~NOTE. C~~t:~~co+e d ~ o..~hor~:~d b~ lo.. +o ~oke ock~o.•bdpTSMS ~s ~o~ ess~or~al ~o+h~ .ol,e~~~ 01 Na~c• e1 F~d~.e! Toa L.~r G.CJM.
~ 2g~ 19, C. 8. 1954 S 1. S. )
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PART ~To b~ us~d for r~cordiny purpos~s
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