HomeMy WebLinkAbout0502 o~'
Fom± 668 DfPNtTMENT Of iHE Tilf/15U1Y-N1iERNAI REVENUE SERVKE Fo. Op~onal U,e By Recordng ORice
~~v i-~o~ . CERT~iGTE Of REIEASE Of ~EDBtAI TAX IIEN ~i
p~~~ . SERIAL NUMBER G~:~ f~ lr~
j4
J~CK~L~NII.t.E 273404 223 6 i~t:x t~".r~~1~;,~ol1AT
~f~ft? iF~:~fEC,....~.....
1 hereby cefify thot as to the following-named taxpayer the requirements of Section
6325(0), Internal Revenue Code, hove been sotisfied nnth respect to the taxes enu- pu ~
merated below,-togeN~er with oll statutory additions provided by Section 6321; and ~ Zl j-n ~'1
tFat the lien for such Mxes and statutory addifions has the~eby bee~ released. The ~~x~~~1
proper ofi'icer in the office where notice of inkmol revenue tax lien was filed on FA
January 2a 191~.. is herebr authorized to make ~otation „ Q,
on his books to show the release of said lien, insofar as the iien relates to the follow- ~!J"
ing taxes.
NAME Of TAXPAY~t
~~r ~i'~0~!
RESIDENCE .
~ $~3~~
i ~ ~ ~i ~
~ ~ . uNPa~ ~?uwcE
~ KIND OF TAX TAX PERfOD ENDED ASSESSMENT DATE IDENTIFYING NUMBBt OF ASSESSMENT
~ (aj ro) (c~ ld1 le1
~ .
Y gil 9-3d~?3 12-10-73 59-12583C~0 ~3 f8T1.7s
~
~
~
F
i
W~{
N
J
a
~p
?1
~
~ '
~ '
C
~
~~C-
~
~ e
z'd
~YN~
i~
'x'~,'3
;
;;y PLACE OF FIUNG
~t ~ TOTAL S
- ' St.e 1i~IG~ CO~R~1'.y 3,~8?1.7s
Pt. Pi~s F2s.
~~r~
~ vVITNESS my hand at Jackeonville. Florida , on this,
=`=''s the 19th day of Febtuaty , 19
` SIGNATURE T1TLE
~i C`t~ ? , -~L ~ tF ~ c
- , u- tft ~ Chief . S~ecial Procedures Staff
ac D r
( TE. hf,~ate oF off~uY c.~tficr:zeJ by !ow to tcke xknowledgments is not esser~hal to the volid~ty of Notice of Federol Tox Cien G.C.M.
i64-}9; ~_B. 1950-51, 125.)
~r~ ~4 PA&E ~kd•
,
a,: PART 3-To be used for recording purpos f
w
~ : = i .
. _ _ ~ - - .