HomeMy WebLinkAbout1402 . . - ~ - - - - . - . . . ~ . . _ ~ , - ---r
, . ` ~
Form 668 • ov~ur~Nr oF n~ t~~wer-a~tr~erut ~t~ s~MCE For Opnond Us A• R.oordrg ORia ~
~v 1ao~ tQTliUTE Of RELEAfE Of iEDBGL TAX L~N ~
DIS1YtlCT SERlA! NUMBER ' M~C
RE Pa111LLt
227140 B201 P669 1XERk C~ttCWT Ct1iMT
RECORS YER~F+EO~...~.......
! herebq certify thot a: ro the fdlowing-named taxpayer the roquirements of Section S,
6325(a~, Inlernol Reveoue Code, Fwve been sotisfied with respett ro the taxes eew ~'~O p~
meroted below, Mgethe~ w.ith alt statutory add'fions ptovided by Sectioa 6321; ond Mrl 1 R
~ fa ~ a~ ~ 2s5433
proper of~icer in the o~ where notios~f mternc~d ravenue tax lie~ was filed on
APril 0 , 19 ~L , is heroby authorized to malce notation -
on his books to show the release of said (ien, iraofar as fhe lien reiates to the follow~
ing fmces.
~
NMAE _QF UXPl,Y6t ~ ~
RESIDENCE
3, a~ri st~?
~ uNran e~u~
qN~ OF UX TAX PERIOD ENDED ASSESSMEIYt DATE lDEPlTIFYING NUAABBt OF ASSESSMENT
ta1 !b1 k) ld) (e1
~~aor~r ~•!~?0 OS•~A•!1 O~i 30 TI~3 ~ iL4.al
~ '
~
i
E
4
~
1
~
1
ff
`
~.ncE oF r~uNG ~
~ °i°'~ TOTAL 3 614.81
s.~.~c o..¦e~
i
~
;
s
~ wITNESS my hand at Jacksonville, Florida , on this,
~ •
~1e 3rd ~y of October ~ 19 73
_
{ SIGNATURE TiTIE
3
Jack Durant Chief, 5 ecial Procedurea Staff
(NOTE: Cert~cote off~ t rized by law to toke ocknowledgmenh is not essentiol to the_validi of Nolice of feder I Tmc Lien G.C.M.
26419, C.B. 19 -Sl, 12
PARr 3-To be used for recording purposes d8
,
~ _
i ~ - - fac" , _
^J
~
~'s , . ~ .
,a . ~ Rn~a-.. _.4: