HomeMy WebLinkAbout2493 1 . . . . . . - . . - . _ _ . . . , .r~.' ' . _ _ . _ . ~ . . . . .r' _ " " • -r~ .
t ~
l p .
Porm 6tS8 ~ DEPARTMEM OF TiE TREASURY-MERNAL lFVENUE SEtY1CE Fw Op~.onol Use By Rccord~ng Of6ce
(REi?. 1-70) C~~~ ~ R~~ ~ T~ ~
DISTRICT SERIAL NUMBER • ~
.~aso~ru~ts ts~~rr? ZZ~92s a2oi pis4~ .c~ x c~c ~
1 h e r
e by c
e
~ t i f
y t hot as to t
h e fo
l lowing-na m e
d tnxpoyer t
h e requirements of Section R F C b
R O Y E 1 t+ i 1~;~
6325(a), Inlernol Revenue Code. hove been safisfied with respect to the toxes enu-
merated below, togeMier with a!1 statutory odditeons prorided by Section 63~1; ond
thot the lien fw such toxes a~d statutory additions hos thereby been released. The
pro~err~f~'ic~4m the ofFice where notic~~f internol revenue tax lien was filed on
i , 19 , is hereby authorized to ~ake notation
o~ his books to show the release of soid lien, insofor os the lien relata to the follow- ~4~~~
ing toxa.
NMAE OF TAXPAYER
Nrda 0 ~ M
RESIDENCE
2!M 0
lwet il~et~i~ ~i4~
UNPAID 6ALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYMG NUMBER OF ASSESSMENT
! Ia1 - (bl (~l (dl le1
101~0 I~¦s 2i~31-70 OS•tZ-~l ~K ~4 ~ ~t~.3Z
~
PI.ACE OF FIUNG
Cj~~C3~1t O~!! TOTAL S fI
~ ~ ~
WITNESS my hand ot Jack somiille, Florida
, on fhis,
the 31st da af October 72
y , 19
~
I
SIGNAT E TITlE
Jac a Chief S ecial Procedure~t Sta ff
~ TE: C afe of officer a aed by (aw to take ocknowledgments is not esseMia~ to the volid~y of Nofice of federo! Tox l~en G.~.M.
26419, . . 1950-S1, i25.) b$C
~ ~ PART 3--To be vsed for recording purposes
,~~4i~?.,~a~~.r~.~r.'='~!~."- ~ ^.n '~5-~2-z,.~_
~ C
r " " ~ Ili