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~P~~~ENT Oi iNE TREASURY- WiERNQ1 REVENUE SERVICE .
~ Form OQ8
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~ ~ FQ- Optfonal Us~ By R~Cwdiny Oflic•
~ (REV. ~-78)
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CERTIFICAlE OF RELEASE OF FE~OERAL TAX LIEN `
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DISTR{CT~ SERIAI NUMBER
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514949
~~s3 Bk 2 sa p~ 3~s
1 hereby certify that as to the following-named taxpayer the requirements of section ~
~ 6325(a), Intemal Revenue Code. have been satisfied with respect to the taxes enu-
~ merated below, together with all statutory additions provided by section 6321; and 9~ ~a~ 27 ~~~+s
~ that the lien for such taxes and stat~utory additions has thereby been released.The
! proper offic ~ in tnQ oHice where notic of intemal revenue tax lien was filed on
Se te~er 3U ~6
notation
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~ cn ihe books to show the retease of said IieR, i~sotar as the lien relates to the follow- Ftt,~GER POiTRr.s
ing taxes. . CLEkK CiRC.~~I CGU3T
i NAME OF TAXPAYER ~ • • ~ ;' ".'t ~~ = -
~o~s a ~aeia sa~~ 514949
~ RESIDENCE
~~ ~~~
- ~arr ~sa~,. a ~t ~
; UNPAID BAL/1NCE
I KINO OF TAX TAX PERIOD ENOED DATE OF ASSESSMENT IDENTIFYIN G NUMBER OF ASSESSMENT
i (a) (b) (cl (d) ~ fe)
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WITNESS my hand at Jacksonvil le, Florida , on this.
the 22nd ~yof Januarv ,19 81
SIGNATURE ~ TITLE
Van E, 0' eaC~ -/"' Chief, S ecial Procedures Staff
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tNOTE: Ce~titicate ol officer authonied by law to take acknowledyments is not essent~al to the val~dlty ol Notice of Federal Tax lien G.C M.
2M/9. C.B. 1950-1. 125.) t~ .
i PART 3- To be used for recording purposes 8~347 ~~-1~~~
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