HomeMy WebLinkAbout1801 . ~ . - - _ _ -T
' FOff11 S • , bEPARi1NEM OF i1~ TYEASURY-~tiERNAL REVENUE SHVICE FW OpI10f10I U! EY RKW(~II~ OH~K!
.~v ~~o) CERTWUTE Of REtEASE OF fEDHtAI TAX UEN f11,E ~ ~~s eECO~F
D~STRICT SERIAL NUMBER fT L,tI~aC c.~Mir ~
.~~Z~ ~ 229151 B 202 P 612
I hereb certi that os to the followi af ~~~:yq~ ~
y y ng-named taxpoyer the requiremenls of Section RE~dRfl Yft'tf~~
6325(0), Internal Revenue Code, have been sotisfied with respect ~o the taxes enu-
merated below, together with a!! statutory oddfions provided by Section 6321; and
thot the lien for such taxes and stotutory addifions has thereby been released. The
proper oPficer in the of}'ice where notice of internal revenue tox lien wos 61ed on
tlgv 1; 19I~_, is hereby avthorized to rtiake notation
; on h+s books to show the releose of soid (ien, insofar as tfie lien relartes to the folbw-
ing taxes.
NAME OF TAXPAYER
J~ • i '!Wr M !1~ ~ ~i•
RESIDENCE
f~ !~s +tstx
~et ll~e+r~ l1~es+i~ b4lO
UNPAID BALANCE
l6iVD OF TAX TAX PERfOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
~a) (b) (d) (e)
101~0 ~~eer 1Z-1L•?~0 0~-St~-7~ ~i+! ~t f~l~3~ ~ ~iT.O!
i
i
i
r -
~
't
~
!
i
' ~ ~ncE oF Fiuric
ai~~ ~ ~t TOTAL S
~ ~
~ fi~t !l+~+O~. !L~!/a
i
WITNESS my hond at _ Jacksoc~ville, Florida , on this,
~ ~OaK ~ P~f I~
' ~1e 14th ~y of June t9 72
3
StGNAT E T1TLE
i
~ Jac ran Chief S cial Pr ur Staff
` OTE: C ~cate of. ot~ice+ au~horized by law to toke ac4nowtedgme~ts is ~ot essent~ol to fhe volid~ty of Nohce of Federal Tax lien G.C.NI
26419 .B. 1950-51, 125.) j~
PART 3--To be usod for recording purposes
~ ~
~ ~ r _ - .
~ a,~~~ - '
~ ~ ~
~
-
y ~ ~ , - -