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Form aee , t1~AIlTME1rT OF TIIE - MrtE1Mll1l SERVICE for Opaalal Uss Bp Rscordirg ONitas
(IIEV. s-~n CERTN=ICATE OF RELEASE OF FEDERAL TAX LIEN -
0{STRICT SERIAL NUMBER ,
372920 B-271 P-1258 4a771~~.
I heroby certify that es to the following-named taxpayer the requirements of section
83251x1. Internal Revenue Code. have been satisfied with respect to the taxes enu• ~ t
merated below. together .with all statutory additions provided by section 8321: and 19~ f EB 26 ti~ ~ 2
that the lien for such taxes and statutory additions has thereby been released- The f EO pc(;p:tut t)
proper officer in the office where notice of internal revenue tax lien was filed on 61~-UCIE C~jl1TY.FlA.
Jute 25 19~~ is hereby authorized to make notation POITRAS
on the books to show the release of said lien, insofar as the lien relates to the folbw- , . C14ECUIT Cn
~ J
ing taxes. ~vo~n ~~>^?:F i-n :i
NAME OF TAXPAYER.
a~ 4'771'71
Oh'rA3 C. d •~R b1C ~Q. `c'C-~
RESIDENCE ? tyo
i
uNVaD EIALANCE
KIND OF TAX TAX PERK)D ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
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{ PLACE OF FILING
~ ~ ~ TOTALS
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WITNESS my hand at Jacksonville Florida on this.
the ?tar day of Fehrt+9r~^ _ 19 30 pp~~c~~?
• B(lal(JGU PAGE
SIGNATURE / TIT
' eal ~ C ef. Special Proced res Staff
(NOTE- CertA~ate or officer authoraed W Isar to take adcnowtedgmsnts ~s not essential to the vaMdAy of Noace of Federal Tax L»n G-C.M.
26419. C$. 1950.1. 125.! C 1 k
PART 5 - To bs used for recording purposes