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HomeMy WebLinkAbout2890 • , t 1. } . 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, - ~~9 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 ~ - t 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 - - - i 4 WITNESS my hand ar Jacksonville, FL _ _ on this, ~ the 21st day May 19 $0 -7 SIGNATURE r _ TITLE Chief, Special Procedures-Staff _ jp r r r - - ~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