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FOfm 66S DEPAATMENT OF THE iRE1WJRY-NTERNAI REVENUE SElVICE FOr OWqraf Ust Br Recadng OlFice
(REV. io-~~) CERTIf1CATE"Of REIEASE OF FEDBGL TAX LIEN fILEO AtiQ AECOROED
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DISTRICT SERIAL NUMBER ROCE~ POITRAS
CLERK G1:;yU1T COURt ~
1 hereby certify that os to the following-narned taxpayer ihe requiremenh of Section RFCOFi V:= ~F1E0
6325(0), Internal Revenue Code, hove been satisfied with respect to the toxes enu- 1o S4 ~u ~~C
merated below, fogether with all statutory additions provided by Section 63'tl; and ~ ~PI J
thot the lien for such taxes and srotutory additions has thereby been releosed. The
. proper oPficer in the office where notice of interncl revenue tax lien wos filed on
T~~.1 v 1 Q , 19_ZS._, is hereby authorized to niake notQtion 3~~'~1w Ar~
on his books to show the release of wid lien, insofar os the (ie~ relates to the follow- ~`tti~V
ing taxes.
NAME OF TAXPAYER
~INp ~~'O~i
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RESIDENCE
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UNPAID BAIANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDEMIFYING NUMBER OF ASSESSMENT
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; ~i o3-3WS ob-u-~s
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_ PLACE OF FILING ~ Q~~ ~
~ $'t'. tUClE OOUNTY TUTAL s i Li6,i~
~ PO(~T pIFRCE. Fl~IDJ~ ~
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~ WI7NESS my hand at Jacksonville~ Florida , on th~s,
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~he _12_daY of September, 19 75
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SIGNATURE TITLE ~
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~ Durant ~ ' Chief S ecial Procedures Staff
(NOTE: Certificate of off' a ~ e y law fo take ocknowledgments is not essentiol fo the validity of Notice of Federd Tax Lien G.C.M.
~ 26419, t.8. 1950-51 2~ 80GK~~~t PAGE 1 P3b
~ ~ PART 3-To be used for recording pvrposes
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