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FORn 66E DEP/1lTMENT OF TME 1kfA5URY-INTERWJ. REVENUE SERVECE (w OWionoi Uft 9Y Recwdng OM~ce
~~v i-~o~ CERT~IUT~ OF RELEASE OF FEDBGI TAX UEN . eiE 0 ir ~
- . SERIAL NUMBER " ~ QQ~s''8t ~A~
CtERK C~ _Cu~T QOUIIT V
~ 2~?7509 Bl RECORO VER+r~Ed~
I hereby certifr that as to the foliowingnomed taxpoyer tne requirements of Section
6325~a}, tnternal Reve~ve Code, have been satisfied with resped to 1he taxes enu- 1 1
~ meruted below, together with all statutory additions provided by Seclion 6321; ond ~~~~c~
~ tiwt the lien for such taxes and statutory additions has thereby been released• The v
prcpe~ afRter in the ofi'ice where nofice of interna) revenue tax lien was filed on
, _ Februiro 8~ , 19~_, is hercby authorized to ~oke notation •
on his books to show the~ release of wid (ien, i~sofar as the lien relates to the foNow-
ing taxes.
NAME OF UXPAYER .
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~~s L1~1s
Ft~tT l3~. rL~O~ ~J~ .
_ UNPAID 6ALANCE ~
~ lUND OF TAX TAX PERfOD ENDEO ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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~ PLACE OF FILING C~IT
~ ~ACis C0~'!'i ~OTn~ S 1.~+6.74
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Jackaonville Florida , on rt,~s,
- WITNES$ my hand at
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the 6th ~y of June , 1973
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~5 SIGNATURE TITIE
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cc:-/~ --a-•~-
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~ Ja rant Chief S cial Ptrocedures Staff
~ (NOTE: Cert e of office? authorized by low to toke «knowledgmenls is not essantid to the volidify of Notice of Feduol Tox lien G.C.M.
26119, C.B. 1950-51, 125J
~ ~25 ~-a~:z ~4Q~
~ PART 3-To be us~d for recordin~ purpos~s t~p~
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