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Fam 668 ` DEll1RTMEP+i OF THE TIfwAJRr-NrE~uu ~EVENt1E SEevKE for Op?iorwl U~ 8~ Recordng OA'~ot
~tt~v t-~o) CHtTIRCATE Of RELEAiE OF FEDBtAI TAX tffN t~t~~yw~~ytu~~r
•3~ilM~l YNlA7•~~i R~.
DISTRIC? SERIAL NUMB6R ,~t
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2(~6~8 Z19 ZZ`J3 RfC^A!+YfRtriCp~~~
I hereby certify lhat as to the foilowing-named taxpayer the requi~ements of Sedion
632 +~a), Intenw! R~ereoue Code; hove bsen sotisfied with respect ro the toxes enu- ~ ~
~~a ou ~~a,? ~aa~ r~o~a~a b,? s~~ 63z~; ~a ~l 1139 PH
Mwt the lien for such taxes and srotubry addfions has tl~eby been roleased. n,~ ~'~599~~
proper oAice~ in the oi~'ioe where notics of internal revenue tox lien was Rled on
n~ t nhor 16 , 19~~, is heroby avthorized to make notation
on his books ro show the release of said lieo, insofo~ as the I~en ~elate: ro N~s follov~r-
ing imoes. - ~
NAME OF TAXPAYBt
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RESIDEWC.E
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IR~IPAID BALANCE
qND OF TAX TAX PERIOD END~ ASSESSMENT OATE IDB~tTIFYING NUMBBt OF ASSESSAAENT
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PLACE OF FILING
C~liC~ ~t ~At~ TOTAL S 1 ~531. ~
b~. I~#~ Cou~Y
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w~TNESS my hand at 7acksonvil ~ e, Florida , on this,
the~_day of February , 19 74
SIGNATURE
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(NOTE: Cert of offscer authorized by la+v fo take ocknowledgmentz is not es:entiol to the validity of lJotice of Federol Tox Lien G.C.M.
~ 26419, C,.-?450-51, 125.) r.r r
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PART 3-To be used for ?etordiny purposes F``~ ~ F~
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