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oBMtMert a tfaEtll~Y - Nnew?t atvEwE far optical w. ey RrooralieAp OMltx
rn~EV ~ - . CERTiFiCATE Of ii£LF.AiE i1F FEDERAL.TAX LIEN
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DISTRICT BERIAL NUMBER
• ~ ~ ~ 434985 8-303 P'-2398
•1 hereby osftity that as to the following-named taxpayer the requiremeflts d section , .
83261x1. Internal AevarNle Code. hew been satis6sd with rospect to the taxes .enu-
merated. bebw. togatltsr with sa statutory additigns=provided by section 6321: and
that the lien f« wd1 taxes and staattory additions has thereby been released. The ~j9 AUG -9 AM II= 36
plopsr officer in the offios where notios d internal revenue tax lien was filed on
February 23 ta~2. is hereby authorized to make notation
on tha books to show the release of said lien. insofar ss the lien relates to the follow- 0 0
EOwFT PA A
T
~ RECORO VERIF~O
RESIDENCE ~ ~ M 16~'g
UNPAID BAU?NCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(ai (b) kl Idl N1
1it M•7i~7r 1i•M•~ ~ lF~~
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LACE OF Fl LING
~~S TOTALS
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WITNESS my hand at ~ JACKSONVILLE, FLORIDA ~
~ 30 day ~ July ~ t9 79
SIGNATURE TITLE
- VAN B. 0' ~ r1,> ~ HIBF, SPECIAL PROCEDURES STAFF DJ -
. ~ (NOTE: Cortitiato of officer suttar¢sd by Ianr to take sdcnorvlsdgmsnts prat assentiar to tM vslitfity of Notice of F~dogl. Tae lion Q.C.M.
26119. C.8..1950.1. 125.1
PART 6 - To be used tw recording purposes 8~~~ ~ f i
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