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Form eee - s~ Fo+ ovrrwu+ use er R.oo+idin~ or,?rr.
~ IREV.3•rn CERTR:ICATE OF RELEAiE OF FEDERAL TAX LIEp
DISTRICT SERIAL NUMBER
387950 Bk 278 P 2802
1 heroby osrtify that ss to the following-nsmrd taxpayer the roquiromsnts d :action
8326(al. Intsmal Reverws• Cods. hsvs been satis5ed with respect to the taxes enu• 19cU ttl~'~ -1} Pti 12. 10
msated bebw. together with NI statutory additions provided by section 6321: and
that the lien for such texas and statutory additions has thereby been released. The f : Ef c~~ F r :
r in t!re afhCS whsra rsatisx of interns! :ms-snus sax lien was Ftlsd on S r t t r ~ , - ~ ~ A
December 19 1~, is hereby authorized to make rwtation I: r_, ~ ,;,;;ti„S
on the books to show the release of said lien, insofar ss the lien relates to the follow- ClF Li~:U:; cGi, T
i taxes. fcta~r. : n_
NAME OF TAXPAYER -
~iis i ~ Sn a. ~OS829
~ RESIDENCE ~ ~ ~
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UNPAID QALANOE
~ KIND OF TAX TAX PERgD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
lal 1pl + Id Idl ld
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PLACE OF FILING ~ ~
~r TOTAL i
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~ WITNESS my hand at Jacksonville Florida , on this,
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the 22nd day of October _ 18 80
SIGNATURE ~ TITLE
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(NOTE- Grtibuu of offrpr autlaratrd W Iatw a u4e scknowNdyrrnnts n rat tasserrtwl to tfrtr vsYbty of Notip o1 FodrrM Tarr lHrr G.C.M.
28~t9. C.9. 1950-1. 125.! ~ ~ t~
PART 6 - To bs used for recording purposes g(~`~ PuiE
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