HomeMy WebLinkAbout0111 - - _ .
'F«m bbg` owNrr,~ oF n+e n~~surr-~ ~v~ue s~nnce rw qor~wwl u. ~y e«ord~ olrc.
(BEV. 1-70~. C~~G~ ~f ~ ~~G~ T~ U~ . lli~i -C
DISTRlCT SERIAL NUMBER ~ ~fOCER
232986 bk204 219 4~EaK c~RCt~R.
RECORU.VfR~~lEO„~,~
I hereby oertify that as to the folbwing-named roxpayer the requi~emenh of Section
6325(a), Internal Revenue Code, hove been wtisfied with respect ~o the taxes enu- s~~
me~rated bebw, t~gether with all stotutory oddfions provided by Section 6321; and ~IL
; thot the I'ien fot such taxes and statutory addilia~s hos tt~eteby been_releosed. The 2~~'~~1GiVa9 ~
proper o~ ~ the oH'ice where no~ f infernd revenue tex lien was 61ed on
Julv 1~ , 19 7~ , is heroby authorized to make notation
on his hooks to show the release of said lien, insofor as ~he lien ~elates ro ~he follovw v? Q,f'
~~ar
ing tmces. ~
NAME OF TAXPAYER
RESIDE
R01xtA 3s Boot 'J49
UNPAID B~AIANCE
KIND OF UU( Ti4X PERIOD ENDED ASSESSMEM DATE IDENT1FlflNG NUMB9t OF ASSESSMENT
~a~ ro~ . (d) lal
; . -
i 1040 IncomQ 12-3i-6T 06-11•71 !!i~ ~B i'~? S 632.72
~
~ 1~4Q Inca~ 12-31-59 Ofr18-?1 2';{ 40 69e3 ~ 7'9~9.I~
~
~
~
~ PLACE OF FIIING
~
: CIeT~, CirCLtlt COttrt TOTAL t I~4~1. 8'~'
~ 9t. LuciQ County
~
. ,
, on this,
~ WITNESS my hand at Jacksonville Florida
~ •
~
~ the 28th ~y of MaY , 19 74
~
~
~ SIGNATURE TITLE
~
~ Jack Durant Chief, Special Proceduree Staff
~ (NOTE: Cerhficat of ~cer au horized by (aw to toke acknowledgments is not essentiol to the volidiry of Notice of Federal Tmc lien G.C_M.
~ 26419, C.B. 1950- 125.) 8mb
~ PART 3-To be used for retording purposes ~
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