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Fam d68 OEMRTMENT OF 7HE iCEAAJRY-NTERNAI REYENUE SERYfCE • FO? Opliaw! lhe Reaor Ol6cs
~REV. ~ a» . C8ti1RUTE OF REtEASE Of f~D6tAl TAX ~1 F~I.EO
DISTRICT ~~K~S~fY~L~ SERIAL NUMBER T. LUCIE COUNTY
ItOCER P01TIlA~
2890Z9 Bk 230, P 2113 CIEaK CI~CUIT CWRt
I hereby certify that as to the following-named taxpayer the requirements of Seciion CORD VERiF1E0
63Z5(a), loter~?ol Revenue Code, have been satisficd with ~espect to the "taxes enu- ~~~~5
merated below, together with all stoiutory additions provided by Section 6321; and
thot tha lien for such toxes and statutory add'ih'ons has thereby been ~eleased. The
proper officer in the offxe where notiae of iMernol revenue tax lien was filed on
~u~ust 12 , 19 74; is hereby outhorized to diake notation
on his books to sfiow the release of said lien, insofar as the lien relates to the follow-
ing taxes.
NAME OF TAXPAYER „
A~! LOM~ Jo~M~o~
RESIDENCE
~'~T ~~IR'~
P~w P1~D~~ ~Ls 33~~
~ UNPAID BALANCE
KIND OF TAX TAX PERlOD ENDEO DATE OF ASSESSMENT IDENTIFlfING NUMBLR OF ASSESSMENT
! (a) (b) Id1 (e~
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~ 9~i3 i2~31~-73 0~?29~7y :~14~6~i3 i4~7:~2.21
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: 9~43 L'~?3~73 09-2~•?3 ~9~-YA~ib~~3 iI~OC0.1~
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€x PLACE OF FILING
$T. UlqE OOU~TY
` ~ORr PIERCE~ ~ TOTAL ; ~J~Tl$.3T
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" WITNESS my hond ot Jacksonville, Florida , on this,
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- the 26th ~Y of March ~q 75
SIGNATURE . T1TLE
~s ~
- • Jack Durant
~ (NOTE: CertiFiwte of outhorized by law to toke ocknowledgments is nof essential to the volidity of Notice of Federal Tax lie~ G.C.M.
~ 26419, C.B. 1950-5 , 125.) d~~~ ~2976
~ PART 3-To be used for recording purposes
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