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F~„ ~g ofnut~r oF n~ r~~u~nr-#rrfar~i eEV~ s~vicf w~ opr;o~ tti. sr R.o~dr~ Q~o.
(~v i.~o1 CQTHCATE Of REtEAfE Of' f~At TAX
o~srwcr J~iw~rrllLy ~f~. s uLL ~u"~R ~ E
.
I hereby ce~iif~? thot as ro the fdbwing-nam~d tax~wyer fhe requirements of Section aE~'c'~C ~@URT ~
6325(0), °lnternol Revenue Code, have been ~tisfied with rospect to the tmces e~u- ~~C~O Y~RIf I p
merared• betow, rogether with oll stotutory add~ions provided br Section 632i; and -
that the lien for such toxes and stabtory odditions hos H~ereby been releosed. The .
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- O~,tn~~A.~ . 19:_I.~. a he~by autFwrized b rrfake notation
oe his books to show the release of said lien, insofer as tfie (ien relota ro the folbvr-
ing tmues. ~ ~ -
NAME OF ~UIXMYER ~ ~ ~
! ~
RESIDENC.E .
i~. ~ ~Mt ~~ir
n. l~a~ lL.~l~
` UNPAI~ BALANCE
IUND OF TAX Ti1X PERIOD END~ ASSESS/~AENT dATE IDENTIFYiNG NUMBER OF ASSESSMENT
Ial rol kl idI (~1
~ ~ Lt-ri-7r s-~-n ~o-z~#7+e0 t~.~
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! ~ PUCE OF FIUNG
' ess+.~.~a o..et
~ , ~ ~ TOTAL s
f ~ i
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i WITNESS my hond at Jaaic~nn~rille ~ Pleridi , on this,
~
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~ the _19.CfL_dor Of ~leL , 19
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SIGNA E T1Tl.E
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NO : GrtiBcote of olficer tfrorized by bw to take ocknowledpreNn~s is nd essent;ol b ~hs vdidfir of Notice d Fedxd Tox tiea G.C.M
19, C.B. 1950-51, 125.) ts
PART 9-To b~ vs~d fo~ r~cor~p pv~pos~s