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, Fo~T bba U S ~REAwRYCEPARTMENT • W~EpM~t.4EvfNUE SERVICf ~~;~t •~~~.~+S.iR~,lr}~~ryd,,,qal/,« ~ j ,~E3 s a~~ CER1fFICATE Qi RELEASE OF FEDERAI TAX UEN I""'"' ~ • ~ ~1STRlCT SERIAL N0.`~ , ~ F P91~2 ° ; 1?~ereby c~?tiFr thot os to the iollow~ng-nom~d loxpoy~~ the r~quirem~ets of Stction e ! 63~5(0l, Int~r~ol R~w.~u~ Cods, ho~e b~~n Sofitfild witN respect ro?he. rox~s enw ~ 1 m~~ot~d ~Ic«, togcthE. w~tk oli stotutwy odditions provided er Section 6321; ond ~ t tl~ot th• lie•• ~w svcl~ ro~es ond srotutwy odditio~s !ws ~l~~r~by been rtl~osed. TM ! prop~r off~cer in t6e o(fics «her~ not~~ce ~o~( ieftrno) ~evenw tox lien rras fil~d on ' ~ptPenber , lY_~.=, :s h~.~by ou~ho-i:ed to nwke norotion ~ i - . ~ o~ Ais books to show the ~eleose of soid li~n~ i~sofor os ths (i~n r~btes to tl~ ~ ' followiny toxes. ~ NAME OF TAXPAYER ` Til~ia a~i Ll3l~ ~ . . ~ RESIOENCE ' ~ ~ i CLASS OF TAX UNPAID BALANCE (To: Rt~urn Foren No.l PERIOD ENOEO ASSESSlNENT DATE IDENTIFYING PlUMBER OF ASSESSMENT (o ) lb) ~c) (d ) te ) ; ~ar~ ss-~-~e 6.s.a~ ~-s~e~ ura~o i ~ ~ ~ . - ~ ; , ~ ~ : PLACE Of FlIIt~G ~ ~s~~ ~ ~ TOTAL S~~ l~` ~j - ; MIITNE55 my hond ot Jacksom-ille, Florida , on ~h~s, - the~ t* doy of Ju~;L-- .19 71 - - - ~ _ StGNATURE TIT LE .lack Duran*. Chief, . ~ Procedurc~s ~t.aff : /NOTQ: C~+~~Hso~~ o~ ~ t~ av by e« o te4• v no..bdpn~q~s i~ nor ess~ne.ol eo tM .al,d~~Y o! Nor~ce o~ F~d.rol 1a¦ ~~en G.C.1M. ~ 2~i110. C.B. 195051. S. ~ so~K 193 2~4 ~ PART 3-To b~ us~d lor ncordin~ pu~poti~s -