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FoKfn V~~ O~pUrtmt~M d thfa Tnpw~?• MtetnM Rw~nw S.fviC~ .
~~.,f.$.~at~,~~e, Certificate of Release of~ Federal Tax Lien -
~i53700 mbar S~a.3~ Fo. ts. e~? R.eo?~d~a ono.
~X ~t~ , Bk 313 Pg 2643 09
F,LfO A FECO 0
I certify th8t as tothe fdlowing-named taxpayer, the requirements of section 8325(x) S R ~ 1T~ A'' -
of the Internal Revenue Code have been satisfied for the taxes listed below and q~
for all statutory addfions. Therefore. the lien. provided by Code section- 6321 for i~ca+o vEacra D
these taxes and addftions has been released. The proper officer in the office
the notice of internal revenue tax lien was filed on August 3
19 ry . is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer
rtillr~' r i frllli~ 1 ~twtlr - -
Residence ~ - -
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of~Asaessrrient
[a) [D) (c) [d)
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f I r~ is-ri-n ~.r ra.~.~ax irrr.M
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Place of Filing ~ atil~s ~t i
!f. ~Ar~irl ~e~ Total = ~i~.M
r~ ~ as~ar E
This certificate was prepared and signed at Jacksonville, Florida . on this.
the 16th ~yofSe temb ~~g 80
Signature Ga _ Title
Van E. O'Nea I" Ch of
i S c a d
! (NOt.: Certificate O/ o[licM authorized by taw fo tike acknowfedymer?n & not essenf[a/ fo~ttM valMiry o/ Mo[/c. o/
E Federal Tax Lien O.C.M. 2A4fD, t~5t}f, C.A. 125_) t~C tam
Part 3 - To be used for recording ieQ, Form 668 (Rev. 5.78)
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