HomeMy WebLinkAbout1367 . _ " ~ . . . . .T. _ . .
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Poim 668 oEr~~Hr oF n+~ reews~xr-~erui e~v[+~uF s~e~ ~ Fo? ~ l us. er R.oo.dGn~ o/Fc.
(REY. 1-70) ~ ~ T~ ~ E~
~ ~ COUMTtr FtA,
' DISTRICT SERtAI NUMBER OCER PO~TR~S
CLERK CIi;~Wt COURT
~~~i1=t 227627 B 201 p 1345 RF~c~R~ v~~,~ifo
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eby certify N,o~ os ro the follow~ng~wmed roxpayer the
r~equ"~remenrs of Seciion i~
632 a, Interna) Revenue Code, hove been sotisfied with r to the taxes emr
merated below, togetfier with otl statutory odditions provided- by Section 6321; a~ M 15
. thot ihe lien fof such toxes ond statutory additions hos thereby been releosed. The
proper o r~ tF~e office where notice ~nlernal rev~enue tox lien wos filed on
Apr~ ~Stn , 19 , is hereby authorized to enake nobtion
on his book: ro show the refease of snid (ien, insofar as fhe lien relates ~o the :ollow-
ing taxas. ~1a.~~
PtMAE OF UXP~YER ~ i~~ ~ y
r.a is ~i ~
~ ty..r.. ~e
ur~i~w e~w?r~
KlND OF TAX UX PERiOO ENDED ASSESSMEM DATE IOHYTIFYING NUMBHt OF ASSESSMEM
ca~ - ro~ k~ a~ ro~ _
.uw~0o v~~~ ~ •
~ 30~i 3~:• l~.i~.~'1 w
` 3M~0 3~;~~ • ~ ~
30M0 3~.~.~6! ii~'i~ " ~!~+~3
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PucE o~ Auwc q~. C~rtix,~t C~t
~ gt. LuCi~ COttflty TOTAI =Z~~~
- Fat t~en~. Flwi~i
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~E
3,: Jacksonville, Florida
~ WITNESS my hond at . on this,
~ -
the IOth ~ of April ~ 19 75
Y
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~ SIGNATURE ' T1TLE
~v i.Ic~.G
Jack Du Chief, Special Procedures Staff
~ (NOTE: i ofe oi oPficer aulhor~zed by low fo take acknowfe;lgments is not essenhal to ihe voliddy of Notice of fedetol Tox Lie~ G.C.M.
26419 . 1950-51, 125.) F.T.
~ Q ~p ~
PART 3-To be used for recording purposeltQ~K~•t70 PACE1~
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