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~r~V. 1•70I CBtTi1CATE Of REtEASE ~f FED~I~I TAX;t~EN
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1 haeby certify that os to the following-named taxpoyer the requirements of Section CLER~K
C RCU
~COYA'f ~
6325{a~, intcr~al Revenue Code, hove been wtisfied with respect ro the taxes eou- RECOIID YEAIf1E0,...~~
meratod below, togethef with all statutory odditions provided by Section 6321; and
thot the iien for such taxes and statutory oddfions has tl~eby been released. The ~ p ~9 ~~I~
proper o~'ic in tfie of~ice wfiere notic4~ f iniernal revenue tax lien was fikd on 0
1'!e~'ah , 19 ~ j , is hereby authorizeci fo Moice noFotion
on his books to show the rele~se of soid lien, i~sofar os the lien ~elates ro the follow- ~
ing toxes.
NAME OF TAXPAYER ~ ~
REStDENCE ~ ~r.
' ~ Z=~~~ tl~'1~ • j~
~
; UNPAID BALANCE
~ KiND OF TAX TAX PERIOD ENDED ASSESSMEtYT DATE IDENTIFYING NUMBER OF ASSESSMENT
~ (ol (61 k1 ldl ~e1
;
_ ~ ~.~.3~.~e S-~-To s+9--a~o~ )o.u
~ y~,3 ~..3i-N S-~-TO ~9-or?~~ ~•i9
~
f
~
~t
~
~
~
t..
- PLACE OF FIUNG 4+~~. C~ti~t C~'~
: js~ j~~ TOTAL S
- ~!t T~sM, lla.
:=t
' WITNESS my hond at Ja~~~~~ , on this,
;
the ~Z'd day of ~C~~Z' , 19 n
= ~ a~oK19? ~~zi29
- S~GNATU TITLE ~
~'s a t (~ief, 9pecisl Proc:edures StafY
E: Cert~ficafe of ofi:cer outhor~zed by law to tore ack~owledymenh ~s not essen~~ol to s+,e val~drty cf Notice of Federol T~x l~en G C.M.
2G419, C.B. 1950-51, 1?S.) ~
_ PART 3-To be vsed fw recording g~sposes ~