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CCQ D~p~rtm~nt of tM TnMUgI • IntMtMl RwMw» S•~vio~ ~
Form OVQ ~ ` .
tp.~, g.p~.,1,b.,,o~, Cenifia:ate of Release of.. Federal Tax llen'
oistriCC ~ s~tal Number 49i~00 Fw ovNanl u.. sr R•~~w orrte.
Jacksonville, FL 327357 B-248 P-2341 ~ 30 ~ ~ 5~
I ~tffy that as to the fdtowing-named the requirements of section 8325(8) EO ~
of the Internal Revenue Code- have been satisfied for the taxes listed below and
for ali statutory additions. Therefore. the lien provided by Code section 8321 for
these taxes and additions has been released. Ttte proper officer in the office _
where the notice of internal revenue tax lien was filed On FphrnAr~ 16 ~ -
19.J1t~. is authorized to note the books to show. the release of this lien for
these taxes and additions.
Name of Taxpayer
Timothy Davis 5 Eugene Scott PTR
Davis ~ Scott Construction
Residence
2807 Ave. H
Ft.Pierce, FL 33452
Kktd of Tax Tax Period Ended Date of Assessment klaMtfying Numbar Assessment
~ W (b) (e) f•)
i
i
941 9/30/74 9/15/75 59-1352618 763.65
940 12/31/74 7/07/75 59-1352618 130.55
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~ -
~ Place of Filing
Clerk, Circuit Court Toil =
St. Lucie County 894.20
Ft. Pierce, FL 33452
This certificate was prepared and signed at Jacksonville, FL , on this,
4th ~ ~ June _ 9 80
Signature ~ T"ltle
Van B. O'Nea ~ Chief S ecial Procedures STaff
(~l•t•e C«tHieat• a onk« .ulnorr:•d by tar ak• .ewwwaaaa~«KS a nat •santw w tho raNdMy a Nade• a
F•f1«d Tvt Lin G.C.Y.26~1q, tY641.C.6. 12b.)
Part 3 - To bs usod for reCOrdirq purposes Form 688 (Rev. 9.78)