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Form 7~ • ~ D~ad~nt's First Name snd Middk Initisl DecedenYs Lsst Name •
(Rw. Jun~ 1977) '
, r.•~; .,:~i;l~ c~~,'',~,',~,~a`l~'~~~s~1:~'; ~1111iam J . MatheBOn
,
p~oeds~t's Socisl Security Num~e~ Date oi Dsath
262-52-7338 t~rch 24, 1978
~ OomidN st Time ot Oe~tA
~ c~w
Florida
United Sta~es To
Certif~cate Discharging ~ ~ ~
Pnoperty Subject 1o APKICANT
ADORESS Mrs. Peggy Matheson, Per- Rep.
ESt8t6 'r8X ~011 /Nuii6er. s~•••?, p, 0. Dscaver 807
c;rr Q? ~own.
s~.~..~o Stuart, Florida 33494
z~P cooe~
L J
I certify that the estate tax for the estate of the decedent ~amed above has been fuily paid ot otherwise provided for. This
certificate discharges the property described below from the lien of the United States imposed by section 6324 of the Internal
Revenue Code. ~
Pffit ATPAiCHED DESCRIPTION ~
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~ SIGNATURE OF
~ June 13, 19'j8
~ o~iciAi~ ~ DISTRICT DlRECTOR
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1ACKSONV~ , FLORI A 32202
Form 792 , t: 77~
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