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Fotm 668 OE?ARTMENT Oe~ TME TREASUlY-MEW/LL lEVENUE SfRVICE ~ Fa Op~iaw! Use BY Rc~cording O/fice
{REV_ ~ a~ CHtTNCATE I~IEASE OF fEDBGI TAX~ l~N
DISTRICT SERIAL NUMBER ~
301649 BZ36 P 1S96 p~,
1 hereby cefify that as b the followinA-named taxpoyer the requirements of Sedion
6325(a~' Internal Revenue Code, have been tQtisfied with respect to the tauces onu-
merated below, together with oll statutory oddtions provided by Section 6321; and
Hwt the tien for such taxes and stotutory oddfions has thereby been released. The
prop~ li'icer in t~ oifice where notite f internol ~evenue tax lien was filed on
- Fe~=~ , 19 , is hereby authorized to nlake nototion
on his books to show the release of said lien, insofar as !!:e lien relotes to the follow-
ing toxes.
NAME OF TAXPAYER
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RESID~ENCE
~'i« ~ R. 3~2 -
UNPAID BAIANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(al tbl k1 (dl te1
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i 9~1 lz~-?3 04~-3D~7~4 l~Si-099A?34 ~t16'~.18
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~g fILED AkD ~~COROED
§ 57. LUCIE ~OUNTY iU.
FiOG~^• =01TRAS `
CIERK :'JI~ COURt
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~ M~ur 15 IZ 19 PM'75
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~ PLACE OF FILING ~
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y ~T P~. F1~A TOTAL S~~.~
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~ WITNESS mr hand at Jacksonville, Florida , on rh~s,
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the 13th ~y of Maq ~ 9 75
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a' .
- SIGNATl1RE TITLE
k rant hi f
. c C e, S ecial Procedurea Staff
~ (NOTE: Cert~ficat of o cer auttwrized by low to toke ocknowledgments is not essentid to~vclid~ of Notice of Federd Tmc lien G.C.M.
26419, C.B. 19 -51 25.) . 6~~K ~rVt7 ~1~~~ B!
PART 3-To used for recording purpos~s
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