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FOfm 66B OEPARTMEM OF 71# TREASIitY-MEWAL ~EVENUE SfNKE For Opfionol Uae By Reco?dng ORic!
(REV. 1P71 ~ Q~ Q~ ~t f~ ~ C
DISTRKT SERU4L NUMBER ~ . ~ ~ ~ ~ i
301072 Bk 236 Pg 823 ' K' }A~
- R~CORB YERt~I ~ ~
" 1 hereby ce~tify that os to the following-named roxpayer the requir~nents of Section = ~
6325(aj,-lnternal Revenue Code, have been satisfied with respect to the taxes enu- ~
merated below, together with oll statutory additions provided by Section 6321; ond ~
thot the lien for such taxes and statutory odd~tions hos thereby been released. The ~
pto f~'icer in t~ ofFice where ootice g~ mternal revenue tax lien wos filed on ~
~e~ilusry , 19' , ~s hefeby authorized to ~rioke notation
on his books to show the release of soid lien, insofor os the lien relotes to the follow- - ~5~~ ~
ing taxes.
NAME OF TAXPAYER
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RESI~~E ~ ~ ~
Pl~'0~~ I~. 3~2
uivPa~ snuwcE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSAAENT
Ial ro1 k1 (dl le1
' 9~1 03-3i-74 04-3(3?7+~ 59~?1~7421 l~ ~+OOQ.36
_
94~1 . 09~?3a-T4 12-.~-~4 ~}I~~?1 1~31,8.31
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~ PLACE OF F~LING 5,~,. `~E ~ _
~ ~'T }'Y,Q~ TOTAL s ~!~$.6'~'
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~ Jacksonville, Florida
ESS my hand at , on this,
the 24th ~Y of July 19 ~S ~
,
SIGNATURE TITLE
r nt Chief S ecial Procedures Staff
~ ~NOTE: Certific of o a outhorized by low ro take ocknowiedgments is not esseotiol ?o the volidiyr of Notice of Federal Tmc lien G_C.M.
~ ~~~9, C.B. 19 -51 s.~ BOOK ~4~ PACE 4~zds
PART 3-To be used for recording purposes
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