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HomeMy WebLinkAbout0704 . . :Y' ..~.-.a•+w/*-~ v _ . , -.a~r _-s~'~~.-~C~. - - ' . ~ - ' ' ~ = . . . . ~ k~ l~ _ . ~ . Fa~m S68 , oEr~rr~Hr oF n+E nfwsu~n~rit~eruA e~vE!+Vr s~v+aE . Fo. Opr~l t/~e sy R.cw~inp olGo. (REV. 1-70) t~U~ ~ ~ ~~~L ~T~ , ~ a~~ r 207202 Bi91. Pi476 ~ ~ ~ I hereby cuti~y N?at as b tfie fdb~^9-~~ ,~er 1he require+ne~ls of Se~ction - ~ 6325(a), tnternol Re~renue Code, have been sotisfied with respect tc the taxrs anu- eneroted below. togelhe~ wiTh oll statutory ad~'~tions provided by Sechon 6321; a~?d '~~.i~ ihat fh~ lien for wch taxes cnd staiutory odd'd'+ons Fws ti~eby been rcleosed. The proper ofi'icer in oi~'ice where of internd ~evenue tax I'ien was filed on ~ ~e wh i Asril 8 , 19 71 , is herebr outharizcd ro diolce notation ~ a, ha books ro show ~he rdease of so~d I~en, insofar as the lien relates to the follow• ~ ~ in9 toxes- - . - i j NMAE OF TAXPAYER ~ ~ _ . £ j RESIDENCE ~ l ~ ~ _ _ UNPAlD 8~?LANCE Klt~ OF UX TAX PERfOD ENO~ ASSESSMENT ~ATE iDHYTIFYING NUM60t OF /~SSES.SMENT j ' (a~ lbl kl ld) (a} I ~ ~~R ~+baa3~t ~ 3~Ip 3~~'a ~ ,~.,~-aJll"1 ~ 4 x ~ yo~o 1~~~ ~ ; , ~ ~ ~ ; ~ ! ~ - r i . , ~ i F ~ l ~ i ~ i 1 ( - ' ! ~ i ~ 1 ~ ~ 4 ' ~ f ~ PUCE OF HUNG ~ Q~s'~IL1 O~~ f ~ ~I~ O~~ TOTAL s ~ - Z~'~ ~Q'~~ i ~ ~ ~ ~ ~TME~ ~ ~ ~ ~acksonville, Florida , on tha, ~ ~ i ~ 20th August ~ 19 ~4 ~ . ~ SiGNATURE ~E ~ c ant~~~~ Chief, Special Procedures Staff TE Certificats of afficer autFwraed by law ro toke ocknovvledgmenh is not asentid to the voi'id+~y o4 Notice of federd Tmc lien G: k 26119, ~.B. 1950-S1, 125.) PART 3-To b~ vs~d for nco~+d'i~g p~+~pos~s - - - _ ~ ~ _ , ~ ~ o-~~ _