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~~8 C~~e of- Re~ts~ ofY Tai t,ie - ~ ~ ,
timid - - - Y s~a11~,~r,ber r t z_ . = Fa, o ur. ~ n.een„~ orb -
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oe~7~fythttasto~hefdtoMrirp~r~amedtatpey~sr, tha~rrequirementsof section 8326~a) -
of ttie Inten~tM Filmrenue Code have been s~iied for the taxes listed below and • s : -
for. aN statetory eddltia~--Therefore. ttlb Ii~Pra~kled b'!~-Code s9C~art 1 for ~ T
thea6 tatter and additions- tbs been r~leaaa~l. T~e pr~Per officer ttoftipe t11tQ YERii?tE0
whet!e the notbe of ir~temal revenue tmt lied:filed on -9 = ~ _
19~_:. is authorized to note the b~,dcs i~ show the release of 'this lien for ~ x
these taxes and additions. a • ~ - - .
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Name of Taxpayer ~ ~ - -
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Ii ~ of Tax Taz Period Ended tats of As~essener~t idsntifyin~ Number ~ _
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Place of Fiing rt
Total =
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Thy certificate was. prepared and signed at Jacksonville, Florida ~ ~
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the 21st ~y~ Se ,1g 79
Si~atwe . ~ Title
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_ Procedures Staff
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