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FOtlll 66H DEPARTMEM OF iHE TRE/ISUR'/-NTEQfJAI REVENUE SERVICE fw Opfionol Ufs ~y Reoadng Office
~~v ~ao~ tatT~1UTE OF RELEASE OF FED~tAI TAX UEN ~fi Luc~E c~ufr~~~
' 239100 B Q6 P2666 C~F
KCC RCU~T
COUQj
y cerh ~hat as ro the follow~~g-oomed roxpaye~ fhe reciu~reme~n of Secnon Rf CQ~~ y~R+FIED
6325(a), Internal Revenue Code, have been satisfied with respect to the taxes enw ~T ~ ~ p ~q
mefated below, together with all statutory odrlitions provided by Section 6321; and it6 `H 13
fhat the lien for such taxes and statutory itions has thereby been released. The
~ in the of~'ice where notic~~nierna) revenue tax tien wos filed on
~ C~O~i-e~ _ 4~~ , 19 , a hereby outhorized to make notation
on his books to show the release of said lien, insofnr as the lien relates to the follow-
ing taxes.
oF ~~Y~ ~ss956
~a2 a naro 1~1Qinzirl
RESI~ENCE
R~ 1, Hou 694
Fo~rt Pies,w ~1o~id~ 33~60
IMIPAID BALANCE
~ KIND Of TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMB~! OF ASSESSMENT
~ lal rol kl ld1 (el
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= I040 Itx.ome 1?~?3I-71 06-~-?2 266 Ob ~i36 S TS4.3?
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- PIACE OF FIUNG
~ CjeS~G= C~Gtt~t COtir'L TOTAL ;
3'~. TJVG3.~ COi~l~
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~~'s WITNESS m hand ot Jackaonville, Florida , on this,
Y
the 18th day o~October , 19 73
eppN ~c
~'3 SIGNATURE TITLE
~ Jack Durant L , Chief, Special Procedures Staff
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_ (NOTE Certificate of ofTc out ori ed by Iaw to take ock owledgments is not esse~riat to ~he valid~ty of Notice of Federol Tax Lien G.C.!A.
26419, C.B. 1950-S1, 12 ~
- PART 3-To be used for recording purposes CC
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