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HomeMy WebLinkAbout2155 i ~ - - ~ - - - ~ - • ~ ..~v/~ . r...e~ i . . ' ' . ForRl 668 O~RiMENR Cf 1F! 71EwS~tJl11-it1[NiAI ~EVElNlE SEIVICE ~P?~ ~ h dO'0^~ ~ (REV._~-70~ CQT/KATE Of RQ~AiE Qf IfDE~AL TAX : . 1 ~ ~ ~~DLL7 r~i.7'f ~ ~ ~ ~~~~Y 1L tir nGwwww~ . ` ~tOCEh PO~TRAt I ! hsreby q~iify #tiot ~ to the folbwirg~rwmsd taxpcryx ih~ roqui~w~+a~ts of 5ection CLEt1K c~iCWT c01MT 6325(a~ IMernal R~sve~w Cods, hws b~sn wlisfiad, with respstt to fbs imc~s e~- RECORO YERIf1E0 meroted be1~?, together wifh all statutory odd'dioos providsd b'f~ Ssetion 63Z1= ad i ~ ~ ~ a~ ~ ~ ~ ~ ~_ps~~~7~ ~ ~o~~~~~~~~~~~~~~ ; xa~ 21 , 19.Z4._..a hen±b~? aurhorizea ro mak. ~a~io~ - ~ ~ ! on his books 1o staw tFis roleose of sad lisn, i~afar.os the lien nlaie: b ths fdbw- . j mQ toxes:___ _ ~ NAME ~ YBt ~ ~ : ~ ~M+ : f _ . ~ - _ , _ ~ ~ ~ _ _ ~ _ . - , lA~/1!D 611LA~KE ~ KIND OF YAX TAX`PEWOD ENDED . ASSESSAAENT ~ATE IDB~tTIFY1NG NUMBBt OF ASSESSMEM' < <a~ ro~ c~~ cds r _ ' ? ! ~t s~~»~ o~~ . i j " . . ! _ y I ~ ~ ~ ~ - I ~ _ . , - ~ . I ~ . ~ . ; i ; ~ ~ ~ PLACE OF RUNG ~ ~ ~ ~ ; ~ ~ ~ - f TOTAL ~ ~ i ~ i ~ ~ ~ ~ WITNESS my hond at Jacksonville, Florida , on this, ~ 16th Q{ December ~ 19 ~4 - SIGNATl1RE ^~,J~ ~E ~ t~ ~ Ja ura t Chief S ecial Procedurea Staff ~ ~NOTE oF oRiar authoriz~d b~r low ro tdce adu~owl~dp~n~b 's not ~~tid io th~ validry of Notice of Fed~d Tmc l;~n G.C.M : 26419, ~.8. 51, 145. P j ~ PwRT 3-To M u~d tor nca~Wq pwpos~s - t~~?~4 ~~i.5~'i ' _ . _ _ ti~~~ s.. - v~~r 3