HomeMy WebLinkAbout0598 . . . . . i . j.: _ : ' 1^..- '_Mr : , t . r;~P.: ' .i'~ • - - ~ ~ .
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F«in 668 o[nUrr~,+e?~rt oF 1?+e teEwsun-~+~ewu. eEVerruE s~wce , for Oa~o~w/ use ey Reco.dng O~ce
{REV. i•74~ CQ~~ ~ ~ T~ ~
as~~r . sERU~ NuMa~ .
Ja~An~a*ill~ 213I6S 0't
I hereby ceitify that as to the following-ncimed to~oyer the requircmenh of Section ~
6325(aj, Internol Rever?ue Code, Fwve been satisfied witfi respec? to the taxes enu- ~ ~
mera~ed belaw, together with oll staturory oddfions provided by Section 6321; oAd CL C1~j11t 4;
thot tfie {itn for suth taxes and s~atutory oddihoru hos thereby been released. The AFCAAQ.YEF tz~~ r,
p~oper Q Ser ~ the off'ice vrhere ~oticeLpf internol revenue tox lie~ was filed on ` f
wu ~ , 19 ~l , is h~eby nuthorized to nloke notation
on his books to show the releose of said lien, insofor as the lien ielotes to the foltow- b ,y
~ ing tmces. • 'f
' NMAE OF TAXPAYER ~c~1AQ~
t~aiV`tt7
Clae~e~ L. Ml~
RESIDENCE
i!1 ~r~~l~N~ ~~r M
~trt Mss~r l~1. ~i4~
tm~Pao e~uwNCE
1ClND Of UX UX PERIOD ENDED ASSESSMENT OATE IDENTIFYING NUMBER OF ASSESSMENT
~al (bl kl tdl (el
10li0 1l~-i1-~t 4~-~i-iT i~-l~-Tils = bi~i.'M
! 10~ 1l-il-<T ~-lf-N iis-l~-Ttli iTe.l1
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~ PLA~E Of FIIING
' i ~t~ t 1OTAL S ~a•~e
1 ~rt r~.ro. ri.
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WITNESS my hond ot Jacksonvill~. Flo=idt , on th~s,
~ 3Yd of Mo~~r . 19 76
B0~ K t~[,~ ~
s~cru?TURf nnE
Jack Duraut
(NOTE: Catificate of o outtarized by knv to toke ockrw~wledgmenh a not aseotid ro the volidi~y of Nd~ce of Fedad Tox lien G.CJN.
26419, C.B. 1950-S1, 1
PART 3-To b~ vs~d for ncordin~ purpos~s rs
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