HomeMy WebLinkAbout1285 - . - . - . ---r- - _ _T . . _ _,Y--• -
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Fo~m 668 oEr~r~Nr oF tae nEwwett-at~e~u~ eEV~uE Fa. Op~orw+ u~. OIRcs
~ ~~v, t ao) CQTfiCAiE Of RBEAfE Of ~QAL TAX t~! ~ IE CO
o+ssr~nc:r s~RUU ~+s~ ~~'~Ea ra '
; ~'j~ 2~6 08 Bl 1 p3~~t - Q1EbK CIRC1~11
I+sreby cutiiy thot os ro ihe following{wm~d taxpopef the requir~ts of SsNion ~0 VEIt1~1e4
6325(a), Inte~nQl IOs~renw Code, hwe b~+ ~olisfwd. vrith respect M ths Mxes enu- t
mKO1d below. Mgether witi~ all stotutory odditio~u.providsd ~p S~ction 6321; a~d ~
thot the lieo for wch roxes ond slotutory odditia~s has thereb~r been releosed. TM
~op~r n the oRice wfiere of intsrnd: revsnue tax lien wos fded on O
~:-I~i~~~,~, , 19 , is henby outhorizad ro e~ioke nobtion
oA his books to siww fhe releose of said lisn, i~ofor as the lien relates ro the follow-
inQ tcucet. . .
NMAE OF TAXPY1YBt
'
RESIDHVCE ~ rs i~ _ . '
~ HI~j
t~AlD BAtJ1NCE
qND OF TI~X TAX PERlOD ENDED ASSESSMEIYT OATE IDENTIFYING NIJI~ABHt OF ~AAENT
(al rol kl (d) 1e1
t
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~ ~ 3~-~f1 i•3i-'!~ !~~l~i~ ~.ls
F .
k
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~ ~
PucE oF F~ur~c~ ti~rrd~ Owef
' ~ ~ ~ TOTAt = -
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v~nn~ESS mr hond a~ J~ ~ s onvi ll.e ~ F lorid a , on M?n,
rhe ~;h doy of ae~t,e~`.er , 19 T1
SIGNATURE TITLE
k TJ~~1~nt ^ o
(NOT : Cert~'icott of ofi'icer outhoraed by law to toke ocknowledgm~nb n no1 ~s~en~ol to t!w voGd~? of Ndic~ of F~d~rd Tox lia~ G.C.M.
~6419, C.S. 1950-51, 1Z5.)
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PAR? 3-To b~ us~d for ncording purpos~s