HomeMy WebLinkAbout2892 t
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Sarin 668 ~ -off oF7tiE newer-a~rrE~ eEV~ sew i Fo. qr~d u+. b R.ooraa olRo.
(ttEy, taoj , C~TiKATE Qf RASE Of ~L TAX.1~1i - -
,
asrat~T . _ . sERUI >•Itl~MBER 253319: _ -
- I _ bertify that as b the foilowit~natntM~ the requirements o~~Ssdion
6~25(rNerrwl Revenue Cone, hove ~ Jodi th respecf ro the facts: e~w- pa@ NAY 2 - ~!i ~ 59
tnprate~'bebw, rogether with all statvtary odditions provided by Sect~on 6321; and ~ _
trot thi>lien for such taxes and :rotatory adddions; hos thereby been released. the '
prpper dRcer in the office where notion of inbemgl revenue tax lien wos filed .on .
jt , 19~„is hettiby authorized ro ttiOke nototan
op his ~s ro show the releose of said.~ien, i~sofoF a: the lien relatef ro the follow- -
irte taxet.
NnME~oF wcPr?YEa _ - 4~~,~„~~
1t~? COA~''I
~ RESIDENCE 1 i. ~ - .
' UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFlfING NUMBER OF ASSESSMENT
~ (al (bI kl - ldl (el
i
s~i i!9l•~l1: 11/2fn 1) ts;~ looo~ ~
~ !i! 7~OOi Of•OS~~ it iSi0i4 lOQi)-~ - .+i~
f _ ~
i ~ -
i -i _ _ -
f
PLACE OF FILING ~1t t
a -
~a .T~MC~! TOTAL
s~,7li.M
E ~ R~e~a 1'loefRi~
WITNESS my hand at Jacksonville. FL , on this,
i
the 21st d,y of 1''~y , 19 80
9
SIGNATURE ) TITLE
Van E. 0' esl: •
(NOTE: Certificate of ofFcer outhorized ~ low tot acknowledgments is not essentid ro the vdidihr of Notice of Fyderd Ta:lien G.C.M.
26419, C.B. 1950-51, 125.)
I PART 3--To bs usod for nsordirq purposes
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