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Form o68 oEn~rH+Ewr oF 1?+E ntEwstm-~rrtE~w. ~vNruE SEMCE Fo. OR'~n ~
~REV. 1-70) ~~T~(A~ ~ ~ T~ ~ .LUCI
~isr~cr SERULL NUMBER ROCER FbITAA
CLERK CIRCUIT COURT
236201 Bl RECQRD YERIFIfO~~..`~
1 hereby certify that as to the following-named taxpayer the ~aquirements of Secfion
6325(0). Internol Revenue Code, have been satisfied with respect to the taxes enu- 1~s PH ~~3 ~
merated below, together with all stctutory alditions Provided by Section 6321; and
that the I'ien for such roxes and sMtubry oddfions hos thereby bee~ releosed. The '~~QO2,
proper ofFicer in tha office where notic~ f internal ravenue tmc lien was 61ed on K
, i 9~, is heroby authorized ro make notation J-
on his to show !he release of said I'~en, insofor as the lien relates to ths follow-
ing toxes.
t~AME OF v1X~AYet giraf.s Yiliage, Inc. ~ a co~rparatfon
RESIDENCE c~ R~iI81diO ~y SOt~th
St. Partersl~g~ Fiori~
l~1PAID BAUWCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENT1FlfING NUAABBt OF ASSESSMENT
la) (bl I~I (d1 1el
y41 09-3Q-?l t~fr~-19-?2 99~-12?.~ 1~382.76
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? PIA~E OF FILING
~ C2erk, Ci~Cttft COt,~?t TOTAL S j~3~.76
° St. Iiuie Coa~ty
_ Ft. Piezce, Flasida 33450
WITNESS my hond at Jacksonville, Florida , on this,
- rhe 25th day of June ,)q 73
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: S~GNATURE~. " TITLE
~ ` 'C<<'/C~i ,Ct_t!~ 1~- f/
= c'Durant Chief, Special Procedures Staff
(NO erl~ficate of ofi'iccY outhorized by (ow to take ocknowledgments ~s nol essential fo the volidity of Nolice of Fed~al Tox Lien G.C_M.
26419, C.B. 1950-51, 125.) '
~ n a 1+~~
~ PART 3-To be used for recording purposes c~ r', ~•1. V~•"~ j ,
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