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~ . Fera~ 66S U. S. TREASURY OEPARTMENT - INTERNAI REVENUE SERVICE Fo? qp.me~ us. es R«ad.~ c.
~ (REV. &67) CERTIFICATE OF RELEASE Of iEbERAI TAX tIEN f lED a~~ RECO
f DISTRICT ~ ~ SERIAL NO. ,S . ~UCIE COUNTY •
tIOGER P81TilA5
~ 197SS! sl8b P2559 eze~!~ c~±~CU~t couRT
j I hereby c~rtify thot as to the followi~9-nom~d toxpoq~r th~ rpuirtn?~nts of S~ctio~ REC~RC~
6325(0), Internol Rsvenue Code, hove be~e sotisfi~d with r~spect to the tox~s enu- ~ A~ O •
merotsd b~lew, to9ether with all stotutwy additions providtd br S~ction 63Z1; ond ~ 0~
tlwt the lien for such taxes ond stotutory odditia+s hos thir~br been ~eleas~d. TM
~ p~oper officer in the office where notic• of int~rnol revenw tox li~n wos fil~d a+
I t Z~~ , 19
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- is 1+ereby authwised to moke nototion ~~~yn
` on his books to show ths release of soid lien, i~sofa~ os the lien r~lotes to tM
( followin9 toxes.
I NAME OF TAXPAYER
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; RESIDENCE
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. , i~up~in a~i ?NCF
~ CLASS ~F iAX - _ _ -
(Toz Reture Fwm No.) PERIO~ ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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; 10~ li.~~ 06.06.i9 ~l~~-~t30
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~ PLACE OF FILING ~ -
TOTAL S
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WITNESS my hand ot Jactavovill~, ZlOtid~l _ , on this,.
the u+tb day of ~7 ,19 72 ~
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SIGNATURE; TITLE
ac4 Dusaat Chi~f, 8}aci~l ls~ee~anrsa Staff
(NOTE: C~rtificot~ of olfic~r o~thori:sd by low to toke ocknvwledymems is not ~ss~ntiol ~o tM volidity of No~ic~ of F~derol To: Lien G.C.A~1.
Z6119, GB. 195o-51, 125.)
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8C1{~1( PART 3-To be used for recording purposes