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} . ixorw b6RF U. S. TREASURY OEPARTIAENT - INTERNAL REVENUE ssRVN:E Fr Op+aMl Uk ~ R~J.M d/icv
r 1~? 1:.a~ ' KATE Oi ~tEASE O!' i~ERAI TAX lEN -
DISTRICT SERIAL N0, -
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1 hereby certify Chet os to the followillR-rowed Nxpoyer.tM tpuirewents of Section
6325(e), Internal Rewnw Code, how been satisfied with respect to tM tuxes env- ~ ~~Y 27
werohd below, to~etMr with all srotutory additions provided. by Section 6321; end G• 59
that the lien for such toys end srotutory additions hss tMreby been released. The '
proper officer in tM office when notice of internal nwnw tux lien was filed on
July 29 14~Q, is herby outhori:ed to woke notation
on his books to show tM release of said lien, insofar os tM lien rekros td tM
followieq tuxes. 'l~t~~11E-flIFKO -
' NAME OF TAXPAYER ~ 3 _
~ ~Xt ~ JOM~>Cr $I10~
RESIDENCE
ai sl A,pRr. ~
t ~t !ice 11la~.~a 3~
i UNPAID BALANCE
TAX FORM NUMBER PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(o) (b) lc) (d) (e)
II ~atbbaidl>~ 3/11 t~tl~ 10-13-67 59T-51?T-70 6,T70.61t
L00~ haalt~
M
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PLACE OF FILING ~~,~y_ ~~iti COUt'~i
bnad~ 0~ TOTAL S 6s7TQ.~1
~'tr ~f~
- NOTICE Of FEDERAL TAX LIEN REfILIN6
~ 235797
IRS SERIAL NUMBER RECORDER'S IDENTIflCATION NO. ~-2.Q5
NOTICE FILED WITH T~,~e~ ts~..~ai DATE 8 22%72 -
TAXPAYER'S ADDRESS ~ _ -
' , . ~ ~f,r~ifferent than shown above)
E SIGNATURE 1~.; - % TITLE ~T~'~~ I~.....~L - - -
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WITNESS my hand ar Jacksonville, FL _ _
on this,
~ the 21st day May 19 $0
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SIGNATURE r _ TITLE Chief, Special Procedures-Staff _ jp
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~NOTE: Certificate of officer authorized by law to take ocknowkdyments is not a:sentia) to the validity .of Notice of Federal Tax lien
G.C.M. 26414, C.B. 1430.1, 1 ZS.)
PART 3-To be used for recording purposes