HomeMy WebLinkAbout2883i
_~ ~ . . - - - -•- - - -- -- ---- -- --- ~: -- .~..----- --^~-~---- - ~ .
! CCp, Departmsnt of ths Treasury - Intemal R~vsnus Ssrvice
,~,A,~,V~~ Certificate of Release of Federa! Tax lien
~, .
District Serlal Number ~`,~ Foi Opliona! Uss Oy Reco~Oiny Olfice
~r ~ MAR 19 11M II= 09
~ ~~~~ 422660 BK-297 -802
' I hereby certity that as to fhe following-named taxpayer the requirements of s i EO ttlf FFCORDE~A
section 6325(a), Internal Reve~ue Code, have been satisfied with respect to the T UCcI ~C~ Y f
taxes enumerated below, t ether with all statutory additions provided by section ~~~"" ""~~
~9 CIERK CtRCU1T 60UR
6321; and that the lien for such :axes and statutory additions has thereby been ,~ ~~
released: The pr er officer in the office where notice of internal revenue tax I~en pE c~r~-. ~ t riF~f 0..._ p~ __,,,,_ _
was filed on ~ovsmber 3 , 1978 , is hereby authorized to ~,~
make notation on the books to show the release of said lien, insofar as the lien
relates to the following taxes. ~~ ~, ~
......... ... .....~...~...
. ~ ~ ~ ~
, Residence - .
=i21 ~ Y - ~ii l~Sw
, ~
Kind of Tax Tax P~rlod Ended ` Oate of Assessment IdsnUfyinq Number
lal . (D/ ~ (c) Id1
~iM ~ ~!/W1~ ~ 0~/!li7~1 ~ 0~0-si~0li2
Unpaid Bslance
of Assessment
(el
~,3ii.34
~ Place of Filing
'r
~ ~~~ ~~ TOtal S ~~~i~.i~
; ~ r~~ ~
I .
` Witne88 my hand at Jacksonville, Florida , on this.
k -
the2~th day of February , 81
~ ~3gnatu:a j T3tl~
Van E. 0'Neal hief s ecial Procedures Staff
(Nolr. Cerfilicefe of oll~cer aufAOrired Dy law lo lake acknowledgmenfs ~s nof essennal ro rhe rand~fy ol No~~ce ol
Federal tax Llan (3.C.A1. 26I19. C.B. t45o~~. ~Z5.1 88
; PB~t 3- TO be used tOr ~eCOrdi~lg pu1p0~~ p~~1 Form 668 (Rev. 4-78)
s i
s
":~'_"r_':`' - °. _ ~._.. _ .... . M'.`.