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IN RE; Estate of f~ ~~Z 2~i3~
ADRIAN M. SAMPLE,
deceased.
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The West 30 feet of Lot 2, Block J, Tyler's Subdivision, +
St. Lucie County, Florida.
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FORM ~9Z DEPARTYENT OF THE TREASURr • INTERNAL qEVENUE SERVICE _
4~ (REV. SEPT. 60) UNITED STATES CERTIFiCATE RELEASING ESTATE TAX LIEN
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: ESTATE OF RESIOENCE AT TIME OF OEATM
Adrian M. Sample 809 Boston Avenue
OATEOFOEATN FOTt P1@TC@~ Florida
ri2 27, 19?1
TO - Nom~ oad oddr~ss of opplicont(S1~o~u Nrw6e?, Saeet. Cit~• or Toae, Stote, Z1P Code)
8t. Lucie County Bank, Co-Executor ~
P. 0. Box 8
Fort Pierce, Florida 33450
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I certify that the estate tax for the above-named estate has been fully paid or otherwise provided for. This cedi-
ficate releases the lien of the United States imposed by section 6324 of the Internal Revenue Code on the property ;
desccibed beloa: ~
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West 30 feet of Lot 2, Block J, Tyler's Subdivision,
St. Lucie County, Florida.
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DIS7RICT OR OFFICE •
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Ja~cksonville, Florida ?
' SIGNATURE ^ ~ TITLE DATE
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Ira S. Loeb Acting District Director July 25, 1972 ~
FORM ~Z IREV. !-6l)
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