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Eore~ 668 oE?NtrMEMr oF n+e twEwsue+r-riiFn~lAl tEVENUE sEev~cE Fa Opriorwl u,e M Reco?d~~g OlFce
~~v i-~o~ CERT~KATE Of RELEASE Of fEDBtAI TAX LfEN ~UCiE COUMTT~
DISTRlCT SERIAL NUMBER
~~~Ifdi ~ 2 0 B 3 P427 ROCER'bITRAf
I hereb certify that as ro the followi med taxpoyer the requirements of Sect~on ~EIIK CIpCWT C9YRT
r "9'"O RECORD VER~FIEQ
6325(a), Intemal Revenue Code, have been satisfied with respect to the taxes enu-
merated below, togethcr with oll stotutory odditions provided by Section 6321; and ~ i,
that the lien for such taxes and statutory addi6ons hos thereby bee~ released. The
proper o1i'icer in the ol~'ice where notice of intefnal revenue tax lien was filed on
,j~mp 1 d , 19?1_, is hereby outhorized to rtiake ~otation
on his books to show the release of said lien, irtsofor as the lien relates to the follow- ~
ing taxa. -
NAME OF UXPAYER
~ 1i i~ it11L~ J ta~i~es
RESIDENCE
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~1~ei l1MO~ *3+~cl~ia ~K~
UNPAID BALANCE
10ND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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~ 10~ Ia~e~r 1~2~3Lii! 06•12-7~0 i~l0 3~ ~MO ~ 2?4.bZ
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0
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~ PLACE OF FIIING
CLl~~ C~ CNlt TOTAL S
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~ WITNESS my hand at Tacksonville~ Florida , on th~s,
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the ~ILday of.~,ntemt~er , 19 7 -
. , 60ROR ~;W YAi.t ~f
VG TURE ~ TITLE
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OTE: ertificote of offic or~zeo by luw to take ocknowledgmPnts is ~ot esseM~ol to Ihe val~d~ty of Notice of Federol Tox L~en G.C.A1.
~ 2~C.B. i950-51, 125.) b9C
PART 3-To be usad for resordiny purposes
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