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' Fo~n 668 oEr~utT~tEWr or iF~ TiFA -11+rE~iAt REV9+UE w. op;aw~ u,. er R.cordng ofFe.
(REY 1-70~ tBTfiCATE OF ~ ~fO~AL TAX ~iI ' `i '
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~ 96 p2023 _
} 1 hereby cerlify d~a~ os b 1he following-naml~ fhe requirornents of Seciion ~ RECORO VEIII , 0.~~
I 63ZS(o~ iniernol Rswnue Code, have b~en ~~I6~~ .respect to the taxas eaw .
~ merated below, 1ogelhir wiM~ all statu+o~Y ad~+ons. Proy+ded bY Section 6321; and ~~1
4 that ths lie» for such toxes ond statutory acl~iliora: has tF~eby been mleosed. The
1 pro1~~~~~c1b~olRoe where not~ob~ ~t~emol reven~e rox ~ien was filed an
~ 19 it her.by ouM~orised ro Niot~e notafion
' on his books to show fhe rdease of said lien, insofor as 1he lian relales M fhe Follo~w-
; in~ taxes. . .
` NAME OF TAXPAYER ~ ~ ~
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RESIDEIVCE ~
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~ - lAVPAID 811LMKE
I KIIVD OF UX TAX PEWOO Et+~ED ASSESSAAEM DATE IDB~Ji1FY1NG Nt1MBER OF /1SSESSMENT
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Pv?cE oF RuNc ~,r,~ als~.~s Mrl?
~ ~ TOTAL ;
wtn~ESS m~? hand at Jackaoavill~ 1 d ~~~a,
~ 8th ~y of May ,19 72 ~
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S~G TURE ~ b00K PRCf ~U~~ '
k Duran ~
CertiRca~e of. oflica~ cvlnorized hy Jo,v so ld~r~ acknawiedgmenb is rw~ msn~id w tl~e valid~r of t~otiat of Fed~rd Tax liM G.CJrI ~
2M19, C.9. 1950-S1, 125.)
?ART ~--To b~ vs~d for roto~ir~ pu~os~s '
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