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. Fam b68 • oEMtfMEPIT oF 7HE nEw9Uer-1NfE1NA1. IBEVENUE,SE~VICE For Opfional 1!u M R dfb
~~v iaoy ~TIRCATE QF RaEASE OF f~D6tAt TI1X tl81 t~E o~rN r~ '
asr~cr s~ Nu?~ a ~ ~~~~~,~a~s
• ~ - Z 2 CtERK ~~AGJ!T COU~t
the roquitemellfs of SeCtioll pF.G4~C Yf~~riE~........~~
1 heroby oartifp ibat os to the folbwing~+wmed ro~
6325(a), IMe~~w) Rave~?ue c«k, have besn safi~isd with rosped to rhe roxes .nu- H' 3
rogeli~ with all statutory ad~tions provided by Sec~eon 6321; ,w~i ~8 f~~w
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~ tfiot the 1'~en for wch Mxes and statu+ory adfiitions has thereb~r bsen released. Ths ~~ii,
' ~obir~8 "~O noNos ~int«nd revenQ~~~ro
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! on his baoks ro ihow ths rotease of said (ien, insofar as ths lien mlobs ro ths follow~
~~g taxas.
MAl~AE ~ TiU(PAYBt
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' RESIDENCE ~ ~ ~ r~ -
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~ UNP/UD 811L/11VCE
' 1CIND OF TAX T/U( PERIOD END~ /15SESSMEM DATE IDB~ITIFYING NUI~ABER OF ~'~S~AENT
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' ' 9~ t'~~0*'~2 O~ ~3,~i~t 13~1.8~
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' PLACE OF HLING . .
CZ+~ ~ ~R ~f.1iLt C~OY!"ti TOTAL ; ~3~s83
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~v:F Jackaonville Florida , on tha,
WITNESS my ha~d at
~':4
~e 14th ~y-of June ~ ~ q 73
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SiGNATURE ~ ~ T1TLE
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G~Ci1~~' ,~,t~cQ-~s'~
ac Durant . - Chief S cial roced r ff
(NC~TE-~~rfificate of officer outhorized by law to take ocknowledgmenh is not essential to the validity of Notite of Federd Taz Lien G.CM
26119, C.B. 1950-51, 125•) r~.17J s'~. -~L~
PART 3-To be used for recording purposes
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