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*o11n'V V V a0M~1 of tM Treasury - .foal R•vnw S•rvic~ 49~~6`
(Rw. S•pl•mbsr 1978) , Certificate of Release of Federal Tax Lied ~ .
District Serial Number Fa opNon.r u.. er R.ooatnQ or?iw
~ ~ 484224 B-330 P-123 . ~ ~ L
I certify that as to the following-named taxpayer. the requin3ments of section 8325(a) ~ ~
of the Intemai Revenue Code have been satisfied for the taxes listed below and
for all statutory additions. Therefore, the lien provided by Code section 8321 for _ ~ f
these taxes and additions has been released. The proper offioQr In the office
where the notice of intemai revenue tax lien was filed on April 24 ~ ~
19~Q_. is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer 4~`it:~4s
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Residence ~ 4 ~ ~
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Kind of Tax Tax Period Ended Dots of Assessment Identifying Number Areessrtreltt
[aI [DJ fc) ft4
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1
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e
Place of Filing
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Lrl~ Ot011f~ Qwilr~inl~rM -Total = !?1.~
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" This certificate was prepared and signed at Jacksonville, Florida ~ ~
t
t11e 30th ~ ~ Jun 19 80
signature ) Tide ~ - -
~ ~ Van E. C~ Chief, Special Procedures Staff
(N~ c«rHkar• a orne•r ~utAortt•e Dr 1sr ro aq M nor •rsseulW ro M• .aia+rr a Nouc• a
F•dNd Tai Ll~n ~.GM. 2M10. 1P6d1, C.A. 126.) ~ Clk
E P~i~Part 3 - To bs used for recording purposes Form d88 iRev. ¢78)
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