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Fam 668 oEMICrMENT OP 1HE nEI~SUe~?-NfE~NAt I~EMUE SHV~CE For Optionoi Use ~ R~cwdng 016cr
~~v iaoi CQT~iCATE OF ~EASE ~ f~D~AL TAX t!@I
D~~~~ i 1 C z ~ 0•? I L L s 2~
Ng g233 P2309 ~`~~1
1 hereby cefify that os b the folbwing-named taxpayer the requiremerih of Section ~
6325(a~, Intenwl Revenue Code, have been sa6sfied with respect ro tfie taxes enu-
merored below, together wifh all statutory additions provided bp Section 6321; and
that the lien for wch taxes and statubry additions hos thereby been released. The
p~r~~r ~the of~'ice where noFio~ Qf inlenwl ~evenue tax lien was Rled on
, 1974 , a heretry authorized M moke notation
on his books to show the releose of said lien, ir~sofar os ihe lien relates to the follow-
ing taxes.
NAME OF TAXPAYER
s~@ ? a sas s ~ro~
RESIDENCE ~
t=~~i ~
UNPAID BAIANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE ID~(TIFlfING NUM66t OF ASSESSMENT
ta) tb1 kl ldl ie1
1~0 li. ~
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CtERK ~3CUIT C~IItT ~
~ . ?ECORO V Rts1E[1.~...~,.... ~
! ~1110 S~ PN'7 .c~~~
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PIACE OF FILING
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TOTAL s
~ Fort Pi~rv~. f1or;~
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~ v~TNESS my hand at Jackaonville, Florida , on this,
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~ the 7th ~y of Pebruary ~ 19 75
~
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~ SIGNATURE T1TLE
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~ ac an~~' ~ Chief
~ (NOTE: Certificote of ffic outhorized by law ro toke ocknowledgmenh is not essentid b the validily of Notice of Federd Tmc lien G.C.M.
26419, C.B. 1950-S1,
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~ PART 3-To b~ us~d for ncoe~ieq purpos~s
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