HomeMy WebLinkAbout2410 . :r. _ . . _ . . _ . - • .7 . . . : . ~
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~ FNiw 6~ ~J S TREASURY OEPARTMENT - INTERHAI pEVENUE SERVKE Fa Oo+.ane~ Use B~ R«vd.++' Off~ce
~ tREY. e•e7'~ CERTIftCATE Oi RELEA OF fEDERAI TAX ~IEN
i DISTR~CT SERIAL NO. lED ~NO
i ~0~ii. lL~1~ it1DC~ER
i i h..•by c~?tify thot os to the foliowmy-nom~..Wxps~r~~ th• rpuu~m~~ts of S~ction ~j
~ 63~S1a), Int~~nol Rev~nw Cod~, hove b~~n sofilfi~d.wit6 r~spee~ to Me tox~s eotr' ~E~~~;~~
~ s+~rotsd ~Ic«, togetM~ wi~i, olf stotutar odditions p.o~~d•d br S~ction 63~1; and ~
~ thot the lien fw sucF? to:es ond statutay cdditions hos th~reby been r~l~os~d. Th~ _
j p~ep~~ olficer ip the of(ice wh~~e notic• oI ii~»:nol r~v~nw tox li~n wos f~l~d on
' A1~Ei13t 2ti. , 1~Q._, i~ h.••br o~d,w~s•d ro nak: nowt~en -
~ on his books to show thc releos• of soid li~n, insofor as tM li~n r~kt~s to tIN
j ~o~~~„~ .ar.s- ~i)9'926
; NAME OF TAXPAYER . ~
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i RESIDENCE - ~
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CLASS OF TAX UNPAID BALANCE
; iTo~ R~turn Fwm No.l PERIOD ENOED ASSESSMENT DATE IOENTIFYING NUMBER OF ASSESSMENT
t lal (b) (c) (d) (e)
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~ PLACE OF FIIING ~ ~~~t
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~ WITNESS my hand ot JBCksonville~ Florida , on this,
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~ rhe 2~tth dey of I'1aY ,19R1
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~ SIGNATURE TITLE
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~ V M L9Mi3
~ 1NOTE: C«+~Hco+s d ofiictr tFwri= d br law to toke ackno.l~dgrn~ms is not ~ss~n ~ol to the v Gd~ r o aice~ • ero ei Li~n . .
~ 26~19, C.B. 19SOS1, 125.) • 93
~ ~i~2 24~
~ PART 3-To b~ u~~d for n.ordin9 purposes
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