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• O~A1tTA181T Of t11E 1RtA51MY - IMTtIMMI IIEYBIIE SfNYltf fa Optional Use 8r Rsrordiny OHice
• InEV i~i~l CERTIFICATE OF RELEASE OF FEDERAL TAX LIEN ,
DISTRICT SERIAL NUMBER FILED ANp~ RECOf~~~~- .
422839 K297 P 1092 ST, I.UCIE COUNTY,' A•~:
I hereby certify that es to the following-named taxpayer the requirements of section 4a~ 1.7V0
83261st. Intsmal Revenue Cods. have been satiaf+ed with respect to the taxes enu-
metaled bebw. together with all statutory additions provided by section 6321: end O
that the lien for such taxes and statutory additions has thereby been rebased. The s79 ~ 2 ~ ~ 9
proper officer in the office where notice of internal revenue tax lien was filed on ~ J~
Novemeber 6 tg 78, is hereby authorized to make notation
on the books to show the release of said lien. insofar as the lien relates to the folbw- ;
; C r. ~ R r0 ~ T R ~
• S
i taxes. CLERK CSRCUIT COURT
~ NAME OF TAXPAYER
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I RESIDENCE
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UNPAID BALANCE
KINp OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IpENTIFYING NUMBER OF ASSESSMENT
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~ PLACE OF FILING `•y~ ~ ~ ~t.
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WITNESS my hand at Tacksonville, Florida on this.
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the 16 day of ~tarrh 19 79 -
SIGNATURE TITLE
~ INOTE Cert~i~cate or officer autlwrub0 try law to take aoicn_owledgmems ~s not essential to tAe valdrty of Notice of iedsrsl Tax Lten G.C.M.
26419. C 8. 1950-1. 12 5 )
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PART 6 - To be used for recording purposes 30Gr