HomeMy WebLinkAbout0218 , U
i - j - ~
~ Form G6H DEP/1RTMENT OF iHE i1tEA5URY-NiERdAi REVENUE SElVKE fa Optionol Use By Recwd~ng ORice c
! ir~v i-io~ CERT~IUTE OF ~EIEASE Of ffDERAI TAl( UEN '
' DISTRICT SERIAL NUMBER ~
I • 206507 B 191 P 383 ~~p ~ ,
i I hereby certify that as to the following-named taxpoyer the requirements of Section
6325(0), Intemol Revenue Code, hrne been sotisfied with respect to the twces eou- f `
~ merated below, together with oll statutory addfions provided by~ Section 6321; and
` that the lien for such taxes and statutory oddi}ions has thereby been released. The ~
proper of~icer in !he of~'ice where notice of interrwl reverwe tax lien was filed on `
I March 23 , 19~_, u heraby auNwrized to diake notation
; on hiz books to show the release of wid lien, insofar os the lien ~elates to the follow-
ing taxes.
NAME OF TAXPAYER ~
s
~ ~1 £
' RESiDENCE
~
T~lt l~1~s s~is
~
~ UNPAID BALANCE
; KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
~a~ ro~ i~~ ~d~ ~e~
, ~
~ s~ ~re ~L.~oa ~.~.ai ~~oooa0.ir a 90..~
~ .
~ ~ ~o ~ ~ ~ L.o~ai ~~u~aorooi ~r : i~
~
~ ~
;
~ ~
;
~
~
~ PIACE OF FIUNG
~ C3~~C~ Q#~1~#t O~Mei ~.06
~ s~ ~ TOTAL ~
~ , ~ t~~
~
~ Jacksonville Florida
~ WITNESS my hand a~ ~ , on this,
~ 0 ~ " ~ ~it ~
the 2 ~th doy of June , ~ q 72 a~~~~
?
~ SIGNATURE TITLE
~ Jack ra ~ Chief S cial Procedures Staff
~ (N : Cer cate of officer outho~rzed by law to roke ocknowiedgmenis is not ~sent~ol to the voGd~tp of Notice of federal Tox Lien G.C.M.
~ ~ . . ~9so-s?, i~s.~ j8d
PART 3-To be used for recording purposes
~ ^~?°~w ' y ~-.~c~..~~
~ ~~~'~k~'~.~r-~.~ ~"''S~'a."~~ . . ~