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` O~MTMENT Of 1NE TI~AS~ MA~IMI ~ fo~ OP~ Usr Br Rldonr~nD Ollice
' ~a~v.6t-~i~~ CEiRIFICATE OF RELEASE OF FEDERAI TAX UEN ~ ~
d~g~~' . SERtAI NUMBER
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I hsreby os~tify that as to the followi~g-nsmed tsxpsrer ~he reQuireme~ts ~ seCtion _ , ,
' 632b1e1. Intemal Revenus Code. Aave been satisf'~ed with resPect to the taxes enu- v, •
~ merated bebw. togsthw with all ststutory sdclitio~s prov~ded bb section 6321: and ~
! chat ths lisn for sud? texes and statutory sdditions has thereby baw~ rolessed. The
proper pff'~ in the offios where notice of internal revenue tax lien wes ~ilod 43`72~i3
July t9 , ta
78. ~s hereby authorized to make notstion ~
' on the books to show the robase of aa~d lien. insofar as the lien relates to the follow- ; 1 S 3 9
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} NAME OF TAXPAYER -
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i RESIDENCE
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~ ~ KIND OF TAX TAX ~ERIpO ENDED OATE OF ASSESSMENT IOENTIFYING NUMBER OF ASSESSMENT
~ Isl lDl (c1 Idl N)
10~17 ~10~ ~1~ 1~~~+~ !l~i0~.73
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PLACE OF fILING
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5:
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§ WITNESS my hand at Jacksonville Florida . on this,
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~ the 9 day of i`isrcti ~g 79 ~
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~ SIGNATURE TITLE
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Van E. O'Neal i; ~.~i~/ - Chief S ecial. Procedures Staff
(NOTE CertA~cace of ott~ce~ author~2ed by Isw to take sCkrwwbOgmsnts ~s ~ot ssssntal to tM vsHd~ty ot Not~cs o1 f~al Tu L~N+ G.C.M.
" 26~19.C8 1950-1.1251 U ~ -
~ 3QG~! ia(;f ~ AC
~ PART 6- To bs used fo? recording purposes