HomeMy WebLinkAbout1493 _ _ _ . . _ ~ ; , ~ ,~--j•-•,T•---
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F«e, 66s oE?~n~xr ~ n+e,~wsu+?-.~ ~ s~ ~
~~v ~-~o~ C~iRUTE Of REtEAfE Of fEDRAI TAX l~l ~LER1c C~aCUiT COURT
DISTRIGT SERIAL NUMSER RECORO YERtPiEO~....~..
21s~o Bl NIYt !S 3 3s PM'1t
I herebr cartify as to the following-named taxpa~rer the roquiremeots of Sectan
6325(0), Internal Revenue Code, hove b a e
n seti s
f
i s d wi t h ~espect t
o t h e taxes enu-
maroted below, together with all statu~ory additions provided by Settion 6321; and ~~,U
that the lien for such taxes ond statubry additions hos tbereby bee~ releosed. The y~
proper o$'icer in the ol~'ice where notice af internai revenue tox lien was filed on
$grtamhwr 3~_, 19~~, is herobr authorized ro make notation
on his books to show tfie releose of said lien, insofor as the lien relotes to the folbw-
ing taxes.
NAME OF TAXPAYER
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RESIDENCE
11~R Qlt1M ~Mt MZ
~ret l~~e~~ t~eW ?1il0
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMB6t OF ASSESSMENT
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= lON I~ar 1~l~i~-r0 6~1~i~•T1 Zi~ i0 ill~ f).t~•~
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~ ~ncE oF Hur~c
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C~~ ~ ~ TOTAL s _
~ S~ttat i~ O~Ry
wITNESS my hand at daCksOrivflle, F1o1`ida , on this,
~1e lOth ~r of 24arch ~ q?2
,
~
~3
SIGNATURE ?1TLE
, Special Procedures Staff
_ Jack
(NOTE: ca~e ou~lwriz law ro roke ockrawtedgments is ~ essentid ro ~he volidily of Nolice of federd Tmc Lien G.CM
26419 .B. 1 - 1, i25.) gg
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