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' ~~v: ~-~o~ . ~ ' CQTHCAiE OF RBEASE ~ ~D~AL TAX LlOi {
DiSTRICT-' JA~'~iJi SERIAL Nl1MBER
2 1 B222 P840
i hereby certifY ihat os to the fdbwin~nomsd taxpa~?er the roqvirements of Seclion
6325(a~, Interool Rsver?ue Code, hove been satisfied with resped ro the taxes enu-
merated belaw. to8etl~x with-all statutory additions provided bp Section 6321; and
thot ths I'~ for such taxes and stalutory odd'fioos has tF~eby been roleased. Ths .
proper oiF'ioer in the oH'ioe where nolice of inlsrnd rev~enus tox lie~. was Rled on ~ •
, Dece~ber 28 , 19~.., a~ a~~ ro moke natation f~~EG R~+~, K~G~ROEa
o~~ his booia ro stww the releose of wid lisn, insofor as ths lien nelatas to tM folbw- s~.~UC1E COUNtY FIA.
i~g tmcss. ROCEP P JN RAS ~
N~ ~ q,ER~ CINGUIT C'." : ~
. ~.~eq VF~NE~.
, ~s ~e ca JU1.15 10 51 ~'i~
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' to~~ ~os ~a~
u~NU e~uNCE
qND OF TAX TAX PERIOD END~ ASSESSI~AENT DATE IDENTIFYING NUMBBt OF AS~SSAAENT
. (o) Ibl lc1 ld) te1
~tt s/~0~ 11/~~ l~M13~1 _ ~ !!0''~1
' ~ W311=! ~/~il7~ lMM7~ l~.i~
Pu?cE oF Flur~c -
~ ~ TOTAL : %
~ilt ljA~ ,
WITNESS my hond at Jacksonville Florida , on N?a.
~ iith ~y of Julq ~ 19 74
/
SIGNATURE ~ Z Q~ T1TLE
Jack Du ~P~` ~ Chief, Special Procedures Staff
(Np : ~ cote of of6cer aothoriied by low to fake ocknowledgmenh is not essentid to the validily ~ 1~h~~d Tmc l~en G.~J1A.
2641 , C.B. 1950-51, 125.) a~ ~~~~kb
PART 3-To be used for recordiny purposes
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