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~~8~..,~ Certi~e of Re~eas~ of= F~decal Tex ~ien~~ - - .
astr~t ~ _ . _ - ro? oplroiw~ fa. R.oase~ oarol?
4~~79~ OR306 rc118s ~ ~ 0~9 ` 10 PM 1= 35
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~ oer~fythatastometab+ai~[-named ~uip~grsr: tha~~qu~r+ernerds of se~io~ as2sca) s
of the int~nnal Riivenue cone tame begin red fw the taxes listed below and A
for ~ may additions. Therefore. the Ii~pr~O~Vided b!? code section t1~321 for a T
these taxds-and additions has been r$teas~d. The proper in office
wt~the notice of internal revenue tipc lielirwas filed on ~pt'il = ~ ~ltlf~EO
19__,r__, is authorized to note the bQdcs~te show the release of : Lien for ~
mess taxes and additions. " - - Y: '4~~ 7~~ -
Name of Taxpayer - -
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Residence .
tinpeid Batance - _
ttMd of Tax Tsx Period Ended Date of As~ssn,ent identifying Number of A:ses:msnt
[al [b) [c) [aD l~,l
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Place of Filing
~t Total :
This certificate was prepared and signed at Jackosmtille, Florida ~ ~
the th day of ~ t .19 7 9 -
re 1 Title
Chief Special Procdeures Staff
Mot1e Gttttleats oI other autAorhad by qw fo wta acltnarladya~ants la not_ assantW to tM Notlq o1
Fadaral Tax Llan C~.C.61.26t1q, fY60~1,C.B. 126.)
Pert 3 - To bs used for recordkq purposes alg ~ t(i~e+?`