HomeMy WebLinkAbout1213 Form Department of the Treasury - Internal Rwenue Service
(Rw.Septemberi978) Certificate of Release of Federal Tax Lien
District Serial Number Fo. Optk~u! use by f~acordMrp otNee
Jaa~Ir~1L~. 502606 1980 OCT -8 P!1 2 33
I certify that as to the following-named_ taxpayer. the requirements of section 8325(a) s
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of the Internal Revenue Code have been satisfied for the taxes listed below and ROGER POlTRAS
for all statutory additions. Therefore. the lien provided by Code section 6321 for CLERK CNtCUIt COURT
.these taxes and additions has been released. The proper officer in the office R~,r,OR11 ~'FRtr)EQ _ Q,~ _
where the notice of internal revenue tax lien was filed on Aaril 24 ~ _
19_79._. is authorized to note the books to show the release of this lien for
these taxes and additions. rj~s~
{ Name of Taxpayer
i a~i ~ 1t~tzl~a 8rs a ~tNeatl+~t
- i S
Residence 1~ ~ ~
lt tl~eeo. fi wit
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifyirtp Number of Assassntertt .
(a) [b) (c) ld)
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i !41 0l~~7~ 03~OS~71 i~l~13~1!'!~t ~,3~3.l~
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Place of Filing
C3~Ile Citrait Cwt
~ ~ it L~s3+B CNS!/ Total = 1s9l3.li
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This certificate was prepared and signed at Jacksonville . Florida . on this,
the 30th day of ,1 ~
Signature Title
edu 8 Leff
(Notac CMtHluh of ofNear auffeortrad by far? to eke aeknow/adpnranta b not assarrtraJ to the vafldtryr oI Motka of
FaWa! Tax LJan O.C.M. 2A1/O, 1b6O•f, C.B. 126.) !I~/'~~ •
Part 3 - To be used for recordirq purpose P~~f~"T~" ~ (Rev. X78)