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FOrm o68 oEP/1tciMErtGOf n+E TltEww~+r-F~ItEW/?t tEVENUE SERWCE For Opionol U~e Br Recadng Ol~ice
~REV. ~ a~ CERTWCATE O~ 1~1EASE OF FEDBtAI TAX LIEN .
DISfiRICT SERIAL NUAABER ~ .~~j~i~~~~
293868 a233 Pi47 ~ ~ ~ -
1 hereby certify that os to the followi~g-named taxpayer the requirements of Section ~~FRlF~,a
6325(a), Intemol Revenue Code, have been sotisfied with respect to the taxes enu-
meroted below, together with all statutory~ add'etions provided by Section 6321; and
that the lien for such taxes and statutory additiont has thereby beea releosed. The .~n~
proper offi'icer in the of'fice where notice of interna) revenue tax tien wos filed on <7V
OCtober 22 , 19_I4, is hereby authori2ed to rriake notation
on his books to show the releose of said lien, insofar os the fien relates to the follow-
ing taxe6. " _
NAARE OF TAXPAYER
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RESIDENCE '
AN = .
l~. P~e~s~ PL 33~2
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
; (al lb) k1 (d) te1
` 941 Oi-3~-74 09-2~-'~4 39-0906~2D 5402.G6
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~a WITNESS my hond at Jacksonville, Florida on rh~s,
e=
~1 rhe 28tb day of March , 19 75
SIGNATURE TITLE
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~ Durant Chief S
(NOTE: ti ote of ofFicer avfhorized br low to take ockr?owledgments is not essentiol to the va{idiqr oi Notice of Federol Tax lien G.C.M.
26419 . . 1950-51, 125.) ~f~~P j
~ PART 3-To be used for ~ecording purposos
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