HomeMy WebLinkAbout1874 t
Form bii O~AtiGMEM OF THE TREASUlY-RJiERNAI REVENUE SERVICE !o?Optlorr/ l/s~ QltReoordrrE 01t1n .
I~ 2741 - - C~ItTN`ICATE OF I!l~LEAiE OF FEDERAL TAX I.iEN .
DISTRICT SERIAL NUMBER 4g~~
1 hsrob,y csrtifythata:tothefollowinp•nomedtoxpoys~ the requtremepts of Section =
6325(0). ,Interpol Revenue Code, hove been wtisfisd with rasped to the taxes snu-
merofed,below, together with all statutory odditiops provided by Section 6321; 'pond ~ NAY 20 ~ ~ 29
that=the lien for such foxes and statutory odditiops has thereby been released.. Ths
proper 4ffker in the office where notke of intbrnal :revenue tax lien was filed.. on ~ A
March 25 19_75is herby authorized to make notation _ '
on his bookstoshowtherslsoseofsatd lien, lA:ofa~ as the lien relates to the follow-
, Ing toxe=. -
i NAME OF TAXPAYER .r
1 ~ • 4S'7t~.
{ RES~ENCE
~r
UNPAID BALANCE
.KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(a) (b) l~l !d) _ le)
Ott yi:~..'j! ~ii~~•f~
i
i
~ _
i }
i
PLACE OF FILING Cif
~ ~ TOTAL : 3.~oeT~
(
k ~ ~
~ F
WITNESS my hood at T~~><Q.,n~•i l] o ~ , on thb,
fi
~ '
the 14th day of_ >KA~ _ 19 $Q
SIGNATURE TITLE
Van E. 0 Chief, Special Procedures Staff jp
(NOTE: Cortikofo of oilk~r ouNar4ed by lo.r b b octnoMrledpm~nt~ b not tswnfbl Io M?o volidRp of Noilco of fod~rol 1o:lNn G.GiA.
2419, C.6.1950 St, I15.) I j
PART 3-To be used for recording purposes ~ ~