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~f ~ ' U: ~REASUiK OEPART T - ~IiElNA? tEVfMJE SElVICE . ~ •
F ~REV. Mov. ivbi~- ~ CERTIFI~ATF OF RELEASE flF FEDEi~?L TAX UEN
~ (Forrta~ly Form 669j _ IT~ M fR ~dw~~ Tes LiMS w~dw:Secti~n 6345 1, I.R.C. of i9S4! •
DlSiRIR _ $ERtAI NUMBER
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i _ . , - 139712 E129 P340 ~
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~ I hereby c~C~ify that as to the following~atned taxpayer the requirements of Section 63251a1, Interncal .
~ Revenue Code'of 1954, twve been sotisfied wit~,res~t to the taxes enum~ated below, together with`-
all statutory cit~fitions provided by Section ~321; cnd that the lien for such tcixes and statutory additions
~ has thereby been releqsed. The proper vfl~cer in fhe of~'ice where notioe of interndi revenue tax lien.
' was fiied on October 25, q65~ hereby airthqrized to rrwke nott~tian on ~is books to show~
the release of~said lien, insofar as tFte lieri ~laf~es to the followin~ taxes. -
~ NAME Of TAXPAYE~ : ' -
~ J~ T. J. ~ ~1. V.^ ~
r~s~oovice oa ~ oF aus~r~ss . _
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' T1fPE OF :1AX ANO PERIOD ? A33E~MEM W1TE R~fRENCE NO. ~ AMOUNT OF
~ ` (a) ~b) ` (c) ~V ' ASSESSAtiENT
1~ 1~~ ~ ' - 5~t9~65 • + 4~'r¦0~~1~ ~~.!'t '
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; Pi/1CE OF HUNG ~ ~ ;r~,~~ ~ ~i~ ~#r
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~ WITNESS my hand at Jacksonville, Florida , on this,
` t~ 4th day of , 1 q ~ 3 . -
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; DISTRICT DIRECiOR OF IMERNAI REVEPlUE BY 1 ~ T171E
~ G~ c-,~ ,4 ~ l~ ief, Specisl Yrocedurts
f A J O'Donaell, Jr. Duraat Staff
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; INOTE: Grtificot~ o o a» w to taks ~ ~
Q R ~dg~ne~ls is nof ~ssentiol 1o tM wlidity of this dotwnsM. G.CM. 26419, ~.8. 1950-1. 125.~
` ~~+L~, PAG~ PART 3• To b~ us~d for ~ecording purpo:~s
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