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~ Certi~icat~: of release ofd -F~~er~l Tax lien
District ~ SNid Number . ~ For ovMoor us..4r R.oaaNw onto.
476795 B-326 P-12s ~ I~AY 27 PM 2~ 59
I certify that ee tothe fdlowing-named taxpayer. the requirements of section 8325(x) ~ ~~o~BA.
of the Intefned R!swenue Cade have been satisfied-for the taxes listed below and
for aN stat~rto~i additions. Therefore. the If~r?-provided by Code section 6321 for a CMrotalT
thes$ taxes and additions has been released. The proper officer in the office ~ vrMFCny...~
the notice f int I - fil ~ ~
wheKe o emal revenue tax ien was ed on a ruarv
19_x_, is authoraed to note the books to show the release of this lien. for
these taxes and additions.
Name of Taxpayer
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Residence ~ -
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' - Unpaid Balance
KMd of Tsx Tax Perbd Ended Data of Assessment Identllrinp Number of Assesanent
' w cn~ tw tan to
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F Place of Filing
~r Total ;
Jacksonville, FL
This certificate was prepared and signed at . on this. ~
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the 21st day of ,19 80
Signature Title
' ief S ecial Procedures Staff
Mot~c C«rHlcar• a k« .urnomw . ro ruc..ckro«a,dym«n. 1. nor «s.nt(d ro rn. vafidNy a Honc. a
Fw.r.~ rx un a.c.~. 2e~rs. ~Qaa~. c.B. ~za.) PI~f2;v07
Part 3 - To be used for recording purposes Form 68S (Rev. 978)
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