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~ oE1AIITMdIT of TIIE TQEASINn - for OPtaa~1 Uss By Ret~adiny Ql/fice
IR~EV. 2-77) CERTIFICATE ~ RELEASE OF FEDERAL TAX LIEN
DISTRI SERWL NUMBER
372915 Bk 271 Pg 1253
1 hereby osrtify that as to the following-named taxpayer the requiroments of section
632b1a1. Interflal Revenue Code, have been satisfied with teepee to the taxes enu-
~ metaled below. togatlwr with all statutory additions provided by section 8321: and
chat the lien for such taxes and statutory additions has thereby been released. The ~ AUG j
proper officer in the office where notice of internal revenue tax lien was filed on ~ ~ ~ Z8
1.,n p 7 S 1 f~
Z_, is hereby authorized to make notation
~ on the books to show the release of said lien. insotar as the lien rotates to the follow- S~~l ~G FEC ~
i taxes.
NAME OF TAXPAYER tX OR
~ ~ i ~ ~ RECORp VERtf Ifp
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RESIDENCE ~ s ~
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uNPaD aAIANCE
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~ KINO OF TAX TAX I
ERIOD ENDED GATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
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LACE OF FILING
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TOTALS
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WITNESS my hand at Jacksonville, Florida on this
the 5~h day of August 1980
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~ SIGNATURE TITLE
1 -1 Chief,"Special Procedures Staff
INIOTE Certdicste o1 officer authored by law to take acknowledgments ~s not essential to the vsMd~ty of Notioe of Federal Tea ~ M.
28419. C B. 1950.1. 125.1 e~G Q~ s
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a PART 6 - To bs used for recording purposes 8~~ P~E~
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