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~ F«e? 66s o~ur??~r oF,r+E,r~suRr--~e~,K ~o, o,x;~w1 v~. ar ~t«ae~q o~.
~~v iaol ` . C~R~tCATE Of ~IEA~ OF ~OQAI T~X UEN FIlEO ANO RECOROEO
f a~~ ~ ~~~R St. [~1ClE COUMTY FU
ROCER PQ)TRAS
s ~ ~ 5 k 203, p e 1795 ~-+c c~RC11IT G~bRT .
i t herebr c+ertify thot os 1o the folbwingrwrns~} bxpoyer. requiraneoh of Section ~ c: f u
~ 6325(0), Inter~al Revenue Code, have been satisfied with respect to the taxas enu-
~ ~at~ together with oll stotuto~y additwns provided bjr Saction 63~1; J~c 26 12 4s PM'78
E thnt ri~e-lie~ for such taxes ond sroh,rory addiiioos hos N~eraby been released. The '
~ proper o!i'icer in the where notice,~ mternai re~ue rox I'ien was filed on
I on his books to ~ow the rdease of soid lien insof~ M,e~Zreiotes ro kthe fo~bw- 41 ~Q
ing taxes. .
~ NMAE OF UIXPAY6t
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! qND OF U1X UX rERIOD fNO~ ASSESSMEM DATf lDENTIFYING NlaMBHt OF ASSESSAAEM
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' Fort P~o~. Fiortda
W17NESS my har?d at Jackaonville, Florida
, on this,
the S day of July 1978
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SIGNATURE . T1TLE
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k ohns Actin Chief ecial Procedures Staff
(NOTE: Cert~fcute of ofT~cer authwe:ed by :aw to toke «knowieclpments is no1 essent~ol to the volidify of Not~ce of Federol Tox Lien G.C.NI
26419, C.B. 1950-S1, 125.~ . ~ ~ - • ~
PART 3-To b~ usad for rocordin9 purposes
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