HomeMy WebLinkAbout2425 . _ . _ _ - .-.~.-..F-- - .
f«m G6$ ' oEr~eu~r~r oF n+E n~wwe+r-a+~tfe~uu eEr[+~t~ m~ncE Fo.
(REV. 1•701 - ~T~w~ ~ ~ ~ T~ ~
DiSTRlCT SERIAL NUMBER ~
2106 ~
' I 1?srebp ceriifp ~hot os ro the fdbwin~nomsd roxpoyer the require~na~ts of Sedion ~ ~ Y~
~~rll ~i
6325(0), Internol Reva~us Code, hQVe ~bss~ ~olisfied wi1h mspect ro the taxes erw-
merot«! be1Qw, togeN~er with oll srotutory oddifioes provided b~? Section 6321; and A
thot tF~e lian for such roxes and sMtulory additia~s Fwi tFbreb~r been released. The ~~1~7~,2
' pro{~er ofRcer ' ths ofTice where oofic~ of inls~nol ~eve~ue tax lien was filed on
Jllne , 19.7~. a heAby authorized to rriake notatan
on Fws books to show 1he rolsose of sc~id lien, i~sofor as the lia~ rela~a ro fhs follaw-
i11~ tNtdS.
NMAE OF UIXPAY6t -
~~it ~i
~~e
~rt a~ ~
l~+t ~¦~r. ~sl~a ~
UNPIUD BAIANCE
Klt~ Of TAX TAX PfR100 ~NDED ASSESSNAENT DATE t~ENTIFYING Nl11NBER OF ASSES~SMENT
ta) rol k1 td1 kl
~ ~ ~ ~ _ ~.i~
PUCE Of HUNG
~ ~ ~ TOTAI S
~
~nnTr~ESS my hond m Jaci~sanville,, Florida o~ r~~s,
htie ~`•h day of ~u2Y , 19~1
yGNATURE TITIE
~
ack ~ ~ ra t ^ ; -
;NOTE tert~Rca~e of o by k~w ~o toie ocknowledgmenh ~s nut essrn!~d to ~he vaLdep of N~~ce of Fedwol To¦ lan G.C M.
26Ii9,C6. 1950-51, ?S. Q~~~
, PART 3-To b~ us~d for ncordin~ putpos~s . ~