HomeMy WebLinkAbout1000 ~ _ . . . - ~v - -
~ fem, 668 oE?~ur~Nr oF n~ n~?wer-~+tEau~ eEVEr~t~ s~ncF ro. op~ono~ u,e er t.oo.d~,p aRc.
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OISTRtGT ' SERIAI NUMBER " r A P8r l
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, t hereb urti fhat as to the followi rwmsd ta T~Od~f ~
Y fY ^9' ~Yer the requiremer?Is of Secfion 9~E~~FI£~„~~
; 6325(0~, Internol Revenue Code, have beee wfisfied with ~o tax~ PM 73
~ merated below, together with all statutory additions provided by Section 6321; ond 1
~ thot the lie~ for such taxes and stotutory additions hos thereby been reteosed. The
~ proper ofi'icer in the ofFice where notice of interno! revenue tax lien wos filed on
Decesbar 28_ , 19_.~1, is hereby autfiorized to moke notation
on his books to show the release of said lien, insofor as the lien relates to tha follow- ~iO
ing tax~s.
NAME OF TAXPAYER
.
' ~1~! ~H!'`~~ .
RESIDENCE
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UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIfYING NUMBER OF ASSESSMENT
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1rQ~p 12-~1-6! . 5-~-?0 ~•TT30 = ~.tl
~ si-~-To 5-s~n k~-~-m~o ~set.os
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° PIACE OF FlL1NG
St~. Q~ TOTAL ~ la~~
tie'S t1~sw, 1~3~rlM
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y WITNESS my hand at Jacksonvitle, Ftorida , on this,
~
- the _QC~L_ day of .7uly , ) 9
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~ SIGNATINtE nnE
3 ` ~tt'~C'-~ .~t?~' .
; ~t Pr eduras Steff
(NOT ~ficote of oH'icer au~horized by low to take ocknawledgments is not asentia! fo the validitr of Notice of Federol Tax Lien G.C.M.
Zb419, C.B. 1950-51, 125.) kas
PART 3-To b~ vsod for rocordirp purposas
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