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Fam 668 oHl1tG~lEttr oF n1E TnEw4JR1?-ME7~lAL iEVFNUE ~VICE For Optiond ihe ~ Reowdriy OfFc+
~r~v ~-~o) C8tT~1UTE OF RBEASE Of ~EDR~L TAX UEN fT~iuC~[acot~~r ft~. '
~~srwa SHaAI tvtu~nBER RocEa a4n~~?=
26007? B 216 2802 ~f~oa~ vE~i
CEI~T CoU#t
I hereby certiify at cs ro the following-nomed taxpa~ the requiremenh of Section
6325(a~. Internal Revenue Code, have been saRt~i'ed vmth respect to the toxes enu- ~n ~
merated below, together with all statutory aldfions provided by Section 6321; ood ~ ~lY ~ oZ PN 73
thot, the lien .for__suc~i taxes and_ statuto_ry_ additia~s.has therebY been _releosed_ The
~ pe~ 4f~Ficer in the ofFice where notice of in?erncl revenue tax lien was Bled on - 2~~`~ -
~ JulY 30 , 19 73, K~y ~rized to make notation
on his books to show the release of said lien, insofar os the lien relotes to the follow-
ing loxes.
NAME OF TAXPAYER -
RESIDE
~ ~ ~
1fw..~ ~R~.iw~_ ~srl~ Y'~R
UNPAID BALANCE
KIND OF TAX TAX PER100 ENDED ASSESSMENT DATE IDENTIFlfING NUMBER OF ASSESSNIENT
(a~ (~1 ~d~
~
I
~ I040 It~a~ 1~3~??2 E~~~T3 14 94.'~4 _ ~~.~0
~
~
~
~
~
€
;
~
~
~
~
~
~
~
~ ~
~
~
~
~
~ PLACE OF FIUNG
4
~ ~C~Oiit"~ TOTAL S ~•lO
:E ~ ¦~1~
~
~ WITNESS my hand at Jacksonville. Florida _ , on this,
~
;3
~e 23rd~y of Auqust , 19 73
~
StGNATURE T1TlE
~
~ _ .
L~~~
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- (NO . ertificafe of officer ovthorized by low to take acknowledgmenls is not asentia) to the validity of Notice of Feder Tmc lien G.C.AiI
= 26419, C.B. 1950-S1, 125.) ~
~ PART 3-To bo usod for ncordin~ purpos~s
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