HomeMy WebLinkAbout2723 444623
OHMTMEIIT Of 111E tEElWl91t - IMTBtfMI for Optiaral Use By Ratordinp Allis
~ IREV.?~i~t CERTIFICATE OF RELEASE OF FEDERAL TAX LIEN -
DISTRICT ~ SERIAL NUM6ER
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1 hereby certify that as to the folbwing-namt)d ~ taxpayer the requirefnents of section
832b{s?. Internal Reverwe Cods. have been satisfied with respect to the texas .enu-
fnerated below.together with aH statutory additions provided by section 8321: and ~T9 anY i s ~ ~ 22
that the lien for such taxes end statutory sdditions has thereby been reNassd. The
proper officer in the office where notice of internal revenue tax lien was filed on L pRE OEO
g.b,,y~y 2't 1912_. is hereby authorised to make notstion ~~~cP01~~f~A.
on the books to show the release of said lien. insofar as the lien relates to the foNow-
i taxes.
NAME OF TAXPAYER RErCORO VEitIFIEO_~-
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RESIDENCE ~ ~ ~s ~ ~ 444623
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- UNPAID BAIANCE
~ KIND OF TAX TAX PERgO ENDED GATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
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~ PLACE OF FILING
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WITNESS my hand at Jacksonville, Florida . on this.
14 May 79
a the day of 19
SIGNATURE / TITIE
V
Van E. Ot ai~~~ Chief, Special Y'lrocedurea Staff
(NOTE: Certdreete o1 officer author¢ad by law to take acknorvNdgments is not essential to tM val~ty of Notice of Fedegl Tea lien G.C.M-
28419.C.B. 1950-t. 1251 0
PART 5 - To bs used for recording pu~j~
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