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HomeMy WebLinkAbout2673 _ _ _ _ _ . _ _ - - - - - - . _ _ - _ ' ~ ~ ~ Fonri 668 ' o~[rMerr of lne n~wwer-~ ~v,Et~x~ sa~ncE Fo. Opiond Uw er t.oorcinp ~ ~ (REV. 1-70) ~ ~ T~ ~ : ; asrwt`r sea~ Ntu+~s~rt . ' ~oo~ ` ro~~~ ~ ' ~ 209s~i u9t sln7 - c~eRK c~wt ' ~ ~ b ~ ~b~ RECORO VERIFIEO.~~~ ' 6325(a~, ~noi Revenue Code, lav~e b~een~so~fisd~'w~th rospe t Io~the tmoes ~nu- ~ ~ ? ~ m~roted :beJow, to8e~i~ with oll stofutory od~iorK provided bp Section 6321; aw! ~a ~ j Nwt the lien for -wch toxes ond statutory additions' has tFare6y boen releosed. Tha . I proper +fT~ ~ ihs ot~ice wl~ere notice of inlernql rm?awe tax lien wos filed ~ on ~~A~~ ` on his b show the rela~e of said lia~, insof~rfhe I~ ~otesf torothe fol~lo~w. . + tm`es' ~ ~ NAME OF TAXPJhY6t 1 , . i I i ' RESIDENCE ~ ~ t~~ ~ ~ ~ I ur~NO e~?uwcE f qND OF TAX TAX PERIOD END~ ~?SSESSMENT DI~1TE IOENTIFlfING NUMBEft ~ ASSESSMENT ~ Ia1 rol k1 (dl (el ~ ~pi0 ~i.~L.~ ]~.1~.~~, ~ ~ i ~ • ? i i ; t ~ ~ ~ ! ~ i I f ' ~ I ~ ~ ~ ! ~ ' ~ i I ; PLACE OF HUNG ~ TOTAL s ~ ; ~r ~ . ~ ' r w~r r~a ; ; WlTNESS mr harxl ot J~Ck~o'~1?illt. tl~siia , on +F?Ls~ ~ _z the ZSth of_ 1~1 , 19_~Z - SIGNAtURE L ATLE ~ w~~ ack Dnra~t ~r~OTE: Certi~cae of oi~ca wrh«aed by low to rake ockrwwledgme~rs a na essen~~d ro ~he v~~a oF fed~rd Tmc lien G.C.M 26119. C.B. 1950-51, 125.~ PART 3-To b~ vsed for n~oedins PurPos~s ~s I ' . i I _ ' !c,~_ S.,'.'_.__~t7 II