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Form 6ES OEPARTMENT OF TME TRBASlJ4Y-NTERNAI tEVfNUE SftY1CF FW Op/ionol UM BY Remrdn9
~eEV_ ~a») CERT~IUtE OF REIEASE Of FEDBtAI TAX t~M .
DISTRICT SERIAL NUMBER F 0 AqD
• 2938 7 a233 ri46 o~~a~P '
I herebr certify !hat as to the followin~-nare~ taxpayer the requiremenis of Section CL RK GI~C ~ ~
6325~ay, Internal Revenue Code, have been sctlisfied with respect to the toxes enu- = RFCORD YF.RtFI_~
me~ated below, together with all statutwy additions provided by Section 6321; and
that the lien for such taxes ond statutory oddjtions ~ hos thereby been ~eleosed. The
proper officer in the o gwhere notia~, f i~ternd revenue tax lien was filed on .
OCtOber ~"l q ; is fiereby outhorized to rriake notation
on his books to show the reiease of said lien, insofa~ os the lien relates to the follow-
ing taxes.
NAME OF TAXPAYER
~ S? ~ ~ l.ilCii
RESID~NCE ~ ~ ~ ~
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Pt. pi~~ P~. 33+R~0
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENUFlfING NUMBER OF ASSESSMENT
~a~ ~b) ~e~
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F 941 06-30-~4 09-23-74 59-1,~Z141S 292.88
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5
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PIACE OF FIUNG
' $T. ~tlClE t~DUMY
~ pEj~,`~ ~ TOTAL S cj~~~
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wi7t~E5S my hond at Jacksonville, Florida , o~ th~s,
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- the 28th dor of Mas'Ch , 19 75
SIGNATURE /I T1TLE
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Du ~ nt Chief S ecial
~R ~NOTE: ~ cote of officer o~thorized by Irnv to toke ocknowledgmenfs is nol euentiol to fhe volidity of Nofite of Federpl Tuz Lien G.C.M.
26~19, . . 1950-51, 125.) O~~~jP~~n~
~ PART 3-To be used for recording purposes
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