HomeMy WebLinkAbout1887 { Form see DEPAR(YENT OF THE iREASUfIr - iNiERNAI IIEVENUE SEtiYCE For Options! Us• By Recordrny Oftic•
R EY. 4-761
CERTIFICATE OF RELEASE OF FEDERAL TAX L N
j DISTRICT. SERIAL NUMBER f LEO ANt r' • aE0
j J ui! 358682 B-264 P-1344 3~. LUCIt::.: _ ~ 5 lA.
Rtc~ , '
I hereby certify that as to the fdlowing~iamed taxpayer the requirements of section Ct E r : R
fi325(a), Internal Revenue Code, have been satisfied with respect to the taxes enu- REC~~" • I~F~•
merated below, together with all statutory additions provided by section 6321; and ~ 2~ ~ ~1
that the lien for such taxes and statutory additions has thereby been released. The
j proper officer in the office where notice of internal revenue tax lien was filed on
_ February 28 19 77 is hereby authorized to make notation
on the books to show the release of said lien, insofar as the Tien relates to.the follow-
, ing taxes. 4~1~
~ ~ NAME OF TAXPAYER
dal4r J. D~tII~ t ~s d. C~,iltls
LMOR~s J. Ql1!'t1a
'i ~ RESIDENCE
~ i 8l0 J!r ~
i !t !1
UNPAID BALANCE
~ KIND OF TAX :TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER ~ OF ASSESSMENT
(a1 (b) (c) (d) (e)
i~ro ~t-31-~3 ~~~i z~~~7
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tq~ -
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PLACE OF FILING
at!'1'~ ~ C~lI~lt ~'t A $t. • Q~e TOTAL S ~#0 •
~ • ~11lN~ ~ 3~,~`Z
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WITNESS my hand at Jacksonville, Florida , on this,
i
j the 30th day of November , ~g 79
SIGNATURE /J ~ TITLE
~ n
~ /v~^ Chief S ecial Procedures Staff
(NOTE Certd:cate of officer author ed by law to take ac wtedyments ~s not essenual to the vandity of Nouce of Federal Tax Lien G C M.