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ONAIItIrHIi OF tIE - rrterMl IIEVBIUE EBIYICE for Option>wl Usr er Reoorr~rlp ONiofr
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~ ~i? CERTIFICATE OF RELEASE OF FEDERAL TAX LIEN
DISTRICT S40 888 BKB290 PG 1214 483142
1 hereby- certify that as to the folbwing-named taxpayer the requirements of section
83251a). Internal Revenue Code. have been satisfied with- respect to the taxes enu-
merated below. together with aN statutory additions provided by section 6321: and APR I S PM 3= 25
that .the lien for such taxes and statutory additions- has thereby been released. The
proper officer in the office where notice of internal revenue tare lien was filed on F1Ll
Q~A~! PR
i Jul 14th 198_. is hereby authorized to make notation ~ R~,~
f on the books to show the rebase of said lien, insofar ss the lien relates to the folbw• aERK CIRCnIT /l
! NAME OF TAXPAYER .
C slur. a. t~..~ 483142
RESIDENCE
r~.a~~
UNPAID BALANCE _
KINO OF TAX TAX PERIOD ENDED GATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
j I Ial IDt ld Id) Iel
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PLACE OF FILING ~ ~ ~t ~t
~ ~ ~ TOTALS M.a
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WITNESS my hand at Jacksonville, Florida . on this..
the loth day of~rj,l 19 ~n
SIGNATURE TITLE
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(NOTES Cert~t/cate of ofhpr authored by Isw to take acknowledcpnsnts snot essent?al to the vsMdrty of Nona of Federal Tea lien G.C.M. eW
28419. C B. 1950-1. 12 5.1 c~
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