HomeMy WebLinkAbout1870 ' FOffn ~H OEPARTMENT Of Ti1E ilEASIlRY-MCTERNAL RPVENUE SfRVICF qnol Use 8y Recnrding OIi'ite
~ (REV. 1471) ~~~u~ ~ ~ ~Q~~ T~ ~ . ~
U~STRICT SERIAL NUMBER . ^ ~Ottft~
JiA~K~G90MVlLLE £~K ~t ~C~iT COVBT
294659 Bk 233 Pg 1175 Rc~;r~n Y~o;~~Cn
I hereby certify that os to !he followin~-named toxpayer the requirements of Section ~
~ 6325(a), Interno) Revenue Code, have been satis8ed with respect b fhe tcsxes enu- ~Z S4 1 K~
merated below, together with oll statutory add~ions provided by Section 6321; ond ~5
N~al the lien for such taxes and statutaty additions hos thereby been released. The ~
prope~~H'ic~r in the off'ice where ~otic~~f interno) reve~ue tax lien was fited on a~'I~ ~
, 19 ~ , is hereby authorized to ~ake ~ototion ~
o~ his books to show the releose of said lien, insofo~ os the lien relates to the follow-
ieg taxa.
NAME OF TAXPAYER
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RESI~ENCE ~
~'t38~tt4~0A '
P~. Pia~~ 1~ 33~62
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFl(ING NUMBER OF ASSESSMENT
(~l I~1 f~l (dl (el
94t Ot3-31-°I4 O~E)8~-?~1 59-141~258 4~9?S•Sb
` 9~~1 ~36-3~-74 14-0'1~-?4 59-~419~'i8 4i232.82
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~ PIACE OF FiLING
- $f. i.tlt;lE O~UMn
; ~ ~ TOTAL S g~~1.~T
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} WITNESS my hand at Jacksonville, Florida , on th~s,
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~ the l4th ~y of I7ay ~ ~ q 75 ~
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~ SIGNATURE n T1TLE
~ n£w~~~ Chief, S cial Procedures Staff
~ (PlOTE: tertiRcote of cer thwizcd by law to toke ockaowledgmenls is not asentiol to the validity of Notice of Federd Tax lien G.C.M
~ 26119, C.B. 1950-51, 1 O!
~ PART 3-To be used for recordfng purpose~~ hds
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