HomeMy WebLinkAbout0844 - .._._.:c ~ - - ~39923 ~ i
Form ~8 U. S. TREASl1RY DEPARTMENT - iNTErtN~~ aE'EnuE SERv~Ce Fo, po~,o~w1 Use By Recasd~.q ON~«
taEV, ,~Fl~ CERTIFICATE OF RELEASE OF FEDERAL TAX UEN ~
D13741CT SERIAL NO. 0 AND RECOROE~
186286 B181 P963 s~W~+E ~Q~n flA. ~
J~~~~ ~O~f ~ POITRAS ~
I hereb certif that as to the followin nomed tox er the re ui~ements o( Sec•ion CLERK C1RCU11 COUItT ~
Y Y 9~ P°Y q RECCRC VE^•~'~ED~.....~-~
6325(a), Inter~el Revenus Code, have been satisfied witfi respect to the roxes enu-
merated bele~«, together with eli stotutory additions provided by Section 6321; and I 4~ 1~~
that the lie~~ for such toxes ond stotutory edditians has the~eby been ?eleosed. The
prope? ofiicer in the office where notice 4 internal revenue tox lien wes Filed on
; December , ~q
6~ is hereby outhorized to moke notation ~9923
~ on his books to show the releose of said lis~, insofor os the lien relotes to the '
followiny tozss.
NAME OF TAXPAYER
g
RESIUENCE
2506 Acran St.
C~ASS OF TAX UNPAID BAIANCE
(Tox Return Form No.? PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(01 (b ) (c ) (d ) ie )
i
~ ~oa~o ~-s~-bs s-3o-~ ~~-oqn ~535.~
~
~
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PLACE OF FILING
CL= I{K~ CIRCUIT CCUR? TOTA~ 3
sT. ~ JCIE OOLti@TT 535•9?
FT. tI'-~RCE, lI.A. ~
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WITNESS my hand at Jacksonville Florida , on th~s,
rhe 13th doy of October ,~q 72
SIGNAT TITLE
ac Chief S ecial Procedures Staff
(NOTE: ~ficote of of(icer outhori:ed by law to toke ocknowledgments ~s not esse~~~ol ro the vol~d~ty oF Notice o4 Federol Tox Lien G.C.M.
261 , .B. 195451.125.)
PART 3-To be used for recording purposes 88