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~ OepaRment o/ the Treasury - Intattul itevenue Service 4 I
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Form sbef
I' ~ Certificate of Release of Federal Tax Lien
!Rev. 8eptemt»r t 978) , _ _
District Serial Number Fa optton.llhe ~ AeeardM~p Dino.
q80 FE8 22 ~M ~ 18
~ .Tatvbs+ri]3+>• 466496 B-320 P-1832
' I certify that as to the following-named taxpayer. the requirements of section 8325(a) f f0 A ~ 0
~ of the Internal Revenue Code have been satisfied for the taxes listed below and ~ C~t~
for all statutory additions. Therefore. the lien provided by Code sedan 8321 for
~ these taxes and additions has been released. The proper officer in the office r,~~eRO ~~a~F+fo_
where the nonce of internal revenue tax lien was-filed on November 19 ,
t 9 79 . is authorized to note the books to show the release of this lien for
these taxes and additions. 4~~~.
~ Name of Taxpayer
` ssars A. cos.oa
Still stal~ia.
Residence
~
~ ~
Unpaid eatsnoe
' -Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessntettt
j ~ (y (b) (W ~ ~ (t)
~ 941 o9-3a''~ ~3-9"99 '~3
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Place of Filing
Closlt oet ~ Cimd! Corot Total = 1363•S3
it. I~3+o Colat~ow
~aaet li~ae~, >~1s.
This certificate was prepared and signed at Jacksornille, Florida _ , on this.
the 14th ~,y of F a X19 80
Signature ~ Title
Van G~ 1 Chief S ecial Procedures Staff
Mdec CtrrtHietatta of olHctar tavfhorr:sd by 1~w to tsx~ acknorHtadpmtrnn 1s ~wr easantlN t valldAy o/ Motlcta o/
Fedsnl Tur L/en Q.C.M. 2e~te, tit, C.B. 126.) Clk
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