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(REV 1-70) ~~~G~ ~ ~ ~~A~ T~ ~
t'~!STpCT SERIAL NUMBER
Florida 183Z66 8-179 P-2975 ~~516
1 hereby cefify that os to the following-named taxpayer the requiremenh of Section ~
, 6325(a~, Intemoi Revenue Code, have been sqtisfied with respect to the toxes enu- ~.ED aK, -~r~.t<i.~'
merated below, together with aU statutory additions provided by Section 6321; and W61E Co~Nry r=~.
that the lien for such taxes and statutory additions hos thereby been released. The poe~-eAs
proper ofl'icer in the offxe where nofice of interna) revenue tax lien was fited on e~ERK C~~CUIRrw~w,i
~BCGN.. VF~~iizD
t~ant~btr 22nd , 19~_, is herebr authorized to make notation ~.a.ra~
on his books to sFww the release of said lien, iiaofor as the lien relates ta the folbw- PM
ing taxes.
NAME OF TAXPAYER
Robart B. Praekop, 1~w B's Appliaace Repair ~35J~16
RESIDENCE ,
316 Orange Avenue
UNPAID BALANCE
KtND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIF1fING NUMBER OF ASSESSMENT
(a1 ~ fb1 ki (dl (e)
941 3/31/69 7/11/69 59 1I14734 11Z.12
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PLACE OF FIUNG
~ Clerk, Circuit Court TOTi41 s
St. Lucie County 111.12
• Jacksonvilla, llorida
WITNESS my hand at , on this,
the 17th ~r of tbveaber ~9 71
~ •
5lGNATURE l~~V T1TLE
Jack ~nt Chi~f. Special Proc~urea Staff
(NOTE: Certificate of offic~ autho?ized by law to toke ocknowledgments is not euential to the va(idily of Notice of Federd Tox lien G.Clrt
26419, C.B. 1950-31, 125. ~
PART 3-To b~ used for racordinp purposes 80CK ~J P',i;tp"b
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