HomeMy WebLinkAbout2132 For~ 668-F U. S. TREASURY DEPARTMENT - INTERNAL REVENUE SERViCE Fa Op~onel Use 8y R.cad~.g ON~c~
~R~?. ~~-dn CERTIFICATE OF RELEASE OF F~ERAL TAX IIEN FI~EO ~YO RECeonrw
nisrQ~~r • SERIAL NO. ~
- - 19~/aY i-to~ rsia3 ~v~i~ Ct1UNTY f~A. ~ -
Jacksonvllle Floi'ida R06ER PpiMAE
1 hK~by c~rtifr thot os to tM followin9-nom~d toxpay~r th~ r~auirem~nts of S~ction CtFRK CIe2~~R ~~~RT!~ t
6325(a), Inttroal Rewnw Cod~, hovt b~~n sotisfi~d with r~sp~ct to th~ ~ox•s •~u- RECORD VFRIFIEO
mtrot~d below, to9~th~r with oll stotutwy odditions provid~d by Stction 6321; ond
thot th~ li~n fw such wa~s ond stotutwy odditions hes tMnbr b~~n r~ltat~d. Th~ wCri s II 49 ~M ~l'
p~op~r offit~r in th~ o(fic~ wh~r~ notic• of int~mal nv~nw tox li~n was 1il~d on
, 11I~, is t+er~~r ovtl+or~s~a to moic~ nototio~
on his books to show the r~leose of said lien, insofor os t1» li~n r~lat~s to the ~199'75
followiny ro:es.
NAME OF TIIXPAYER
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:.9yi]Q~ ~O~Y'
REStDENCE
323 s. 13tb stsr~~
3 ?ort Pi~ro~ Florida
E UNP!?ID BALANCE
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~ TAX FORM NUMBER PERIOD ENDED ASSESSMENT DATE fDENTIFYING NUMBER OF ASSESSMENT
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~ l ~l,0 12-31-b2 7-15-SL b~-?L-v377 ~?192.07
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PLACE OF FILING Gircuit t~o::rL
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NOTICE Of FEDERAL TAX LIEN REFILIN6
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198 ~ H18~
IRS SERUL NUMBER _ rjs _ _ _ - _ - _ RKORDER'S IDENTIFICATION NO. _ _
Piarce, Flori~a
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NOTICE FlLED WlTM i.Is~I~-_3:~t~S~. Se]Y~es ~t~_ I!13~1~CA1tA~l,-_ F0=`t!_I DATE ~ g-1 -T_
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= TAXPAYER'S ADDRE55 . - ~ - - - - - - - - :
; ~H different thon shown above~
SIGNAT(JRE _ ~A~~ L~ ~ ~J TITIE _ ; - ^
.~ec~.__ - / ? ~?t ':w~..n ~s~tir~o~ aA~ Q hQ ~ . .
~ o Ti - ~ ,
WITNE55 my hand at _1S,lCk.S~Y~~ ~OY"~d8_ _ - - , on this,
~ the-2~h - -day of ~'1_4V~bAT--- , 19-?1-
- SIGNATURE ~~k - TITLE C~~2- ~n~ ~~e~ ~~P
Y aooK 1~7 PacE~30
~NOTE: Ce~tificate ot officer outhorized by low to take ocknowledgments is no1 esscnreal to the validity of Nofice of Federal Tox lien
~.C.N.. 26~19, C.B_ 1950-1, 125.) aa
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PART ~To be used for recording purposes d ~