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HomeMy WebLinkAbout2039 _ ~ _ _ _ _ _ _ _ _ ~ ~ _ ~ V~- - ~ - - f~ .~,.~rc.::ae Bs Racad+~ Fe~~ ~g U. S. TREASURY DEPARTMENT - ~nTER a~ REvEx~f SE~YKf Q`"• .aev. e-s~s~ CERTIFICAIE ~~tEIEASE OF f~DERA[ TAX i~N ~ DISTRICT ' ' SERIAL NO. ~ ~R ~101?jRl~ ~ d~i0~d71~ !10!'S~i l~COlt~ YEPIFIEO ~ ( l+ereby certi(y thot os to Ihe ioilowi~q-noined toxpoyer the reQu"uemants oi Sect~on 6325(01. I~ternol Revenut Cod~, hove been satisfied w:tF~ respec~ to t!~ to:es snu- meroted be1c~M, toqether with oll sto~uto?r edditions prov~ded br Section E321; ond ~ that the lien iw such toxes ond stotutorr odditiaes Ms the~ebr been releese3_ The ~n(1~ pcoper ofiicer i~ the office where notice of internol revenue tox lien ~ros f:led oa vti iunR 16 , 19~., ~s he~eby o~thw~zed to ~wake noat+ea ~ on his books to sho« tF~e r~lecse oi soid lien, insofor os the tien ~slotes to ttw Followiry ta:~s. NAME OF TAXPAYEit ~ - ' ~ RESIDENCE ~ , ~ ~ i ' CLASS OF TAX ~ UHPAtD $ALANCE ' ~ (Tax Retam Fwm No.) PERIOD ENDEO ASSESSMEN?_DATE ID=1:;IFYING NUM$ER OF ASS:SSYENT ' (o) (b1 (c) (d) j-: t • Z j~Q ~'1~'~ ~ ~ ~ ~ 2Z90 6-j0-10 9-]~!-~! ~1 69~i ~d00~ ~0•0~ - _ °LACE OF FiLING C~~' ~t ~t ~ ~ ~ TOTAL S~s* ~3+~ WITNES~ my hond at Jacksonville Fiorida~ ~~~5. the_ 3rd dQy of Se~teobeL, i97~ SIGNATUR TITLE a"~G ed~ras Staff : Chief . Svecial proc fNOT : Ce icote o~ o~fic~r outhori:ed br !aw to ~o4e ock~+o~ltdgr.ears +s ~o• esse~•,ol to shc .oI~d~t~ d ti~ice of ~:deal 7o L• e* G.CJII_ . 2~~ . .s. ~vsasi. izs.~ ~ R ~tJi ~lh)~ ~ ~~X PART 3-To be used for ~ecording purposes _ - - - ` T;~ ~ d:~ ^a