HomeMy WebLinkAbout0597 . ~
, , 3.i(~Q~ C
~ f«m 668 oa~r~?~r a rnE ~vs~n,E se~ ~o? opo~a+ u.. er A.oo.d~„a o~o.
i I~v. i-ro~ CqtililCAYE Of RELEASE OF fED~AI TAI( LIBi
; DlSTRICT SERw. NuMBER ~ .
293k444 b ~Q ~ ~t
~ I hereby cer~if~ ~hat as ro the following-rwmsd roxpayer ?he requ~reme~ts of Secrion 9~~ ~~i~~ ~
hove bsee wtisfied with r to the toxes enu b0 @ E~
~ 6325(a), Inie~no) Revenue Code, espect .
' me~ated below, together with oN stctutory odditions provided by Section 6321; ond ~ s~ PM~6
~ thot the (ien for such taxes nnd statutory addi6ons iws thereby bee~ ~eteased. The
f proper o~c~r mtj~q office where notice intemcl ravenue tax lien was Rled an
~CODeX ly • , 19~, is hereby authorized to make notation
~ on his books to show tha ~elease of said liee, insofa~ as the tien relates to the folbw-
i ing taxes. -
~ NAME OF TAXPAYER •
;
i
' RESIDENCE
` 7~M ~a'~ ~lMi
' ~ uNPau eAUwcE
KIND OF TAX TAX PERIOD EN~EO ASSESSMENT ~ATE IDENTIFYING NUMBHt OF ASSESSMENT
' fol lbl kl (dl lel
~
i
lii0 1!•ri-~T ~+17-i~ iM~+~rti~ it,!l.ii
;
~
: .
' .
;
;
; ~
;
; .
,
~
PLACE OF FiUNG -
~ ~ TOTAL ;
Fo~! PNrcl. Fiorfd~
; i
W/I1TIESS mr hand ot 1acl~snnville, Fterida , on tfiis,
~ 3rd ~Y oE November ~ q ~
.
sao~ ~act
SiGNATUP.E nj~
Jack.Durant ~
(NOTE: CertiAcote f officu wthorized by law ro toke ocknowledgmmis is nd esseMid to ths volidiy of Notice of Fede~al Tmc lien G.C.M.
26419. C.B. 19 , 125.)
PART 3- Ya b~ us~d for ncordin~ purpos~s a s ~
I