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, 1. ~
~ Form 6~8 DHARTMENi oF 1ME 11EwSt1RY-~N1E~tIl lEVB~UE SE[VICE ~~10i"0~ ~ Sl' R~ODfd"'D ~
(REV. 1-70) - CQTHCATE Of RaEASE 0~ ~D~AL TAX L~N F LEO ANO REC~it~EO
s~. ~uc+E cour+Tr
DISTRfCT N~~ ~ ROCER P0ITRAS
219977 - B297 PZ132 CLEaK CiRCUIT COURT ~
I hereby certifp that os lo ihe following-nornsd loxpaYer 1he n4uireme^h of Section R£COR[? VEFIFIEO
6325(0), inMrno) iEevenus Code, have bee+i satisfied wifh resPed ro the taxes enu- ~ ?
merated below, together with all statutory odditwns provided bp Section 6321; ond a S~
thot ihe lisn for such taxes and statutory odditions has N~ereby bea~ roleosed. The ~~~~~7
proper oR'~ in the office where notics Qf inierna) revenue tax lieo was filed on
Dlc~~bes 6. , 19 7i , is hereby authorized ro maka ratotwn
on ha books ro show the release of said lien, insofor os the lien relates to ths follaw-
ing Mnes.
NAME OF UXPAYER
RESIOENCE '
r. a k 4~6
1~ uNPa~ B~?tawcE
' KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDH~ITIFl(ING NUMBER OF ASSESS~AE ~
(a) Ibl (~1 ~d~ .
10M0 3Z.p.?'~ 6-0~.71 ~.9~lS•Aa
~
~ncE oF Fwr~c
~ *~M
~ TOTAL =
:i
~ + ort Pierw. Flori~ii
~
~ W17NESS my hond at Jackaonville. Florida , on ~his,
b~~ -
tl,e ~~5~ day of June , 19'~ 2
SIGNATURE ~E
a ief cial Yrocedures Staff
( : CertiRcate of oH'icc~ outFwrized bp law to take «knowledpments is not essentid b th~ vd'~? of Nolioe of federd Tmc lien G.CJrI
26419, C.B. 1950-51, 125.) i•
PART 3-To b~ vs~d for ncordieq pu~pos~s
4?* ' 'w '
~~'CL3'~Y'e'att~vrF~':'£_ .3~'r'~r y ' -
3 ~ 'S''"ti.'~ ~ 3` _ P'-~ ~G-~,~.
~
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