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~ Form 6d8 oa~~r oF n+e n~wSUnr-i+tFe~u-t ~vEr+uE ~
; ~~v ~ iao~ C~TlKATE Of R~EASE OF l~~tAl TAX t~l
~ a~ ~~~~ BK 232 Pg 1689
, .~i0nr~ll~
`! 1 hereby oertify ihat as to the folbvring-nomsd taxpayer the require+nenls of Section
' 6325(a), lobrna! Revenue Code, hove bsea sntisf'ied with respect ro the taxes enu-
~ merated below, togetF~er with all statutory additions provided b~- Section 6321; a~d
tFat the lien for such taxes and statutory addfiora has tF~eby been released. The
; proper of~ in fhe oA'ioe where notice~p~ interna) rev~enue tax lie~ was filed on
(k~tnh~er 3 , 19 , a hereby auN~orized to moke nototion
on his baoks to show the rele~e of said lien, insofar as the lien relates to the follow-
. ing taxa.
NAME OF UXPAYHt
~ass ~. ~~cx ts
RESIDENCE
` ~ ~~ ~~
' ~0lt ~.~s ~~Mp~
~ op~+ u,. er g.oo
~~
-- . - - _-~
g ~.--~ I
1991 MAR 18 ~II tl= 09
~~~.~~~~'~~-~"-
CLERK CIRGNT C4tlR
:rRn ~~Fe~F ~en. _ _
Sw`~28
UNPAID SAIANCE
OF ASSESSMENT
Iel
; KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMB6t
' ta1 (b) k1 ~d1
3A~-lT ! ~~ 7~ ~ 04•t~~4
I
PLACE OF HUNG ~_ ~t ~,r
~ pt,. ~j !~. ~~Z
3~9~.2i •
TOTAL I = ~~~~
y~TMf~ ry,y ~~ af Jacksonvill~,, Flnridn , on this,
~ 27th ~, af Februarv 19 S1
51GNATURE -
Van E. 0'Ne
(NOTE: Certi6cate of ofFcer
46419, CB. 1950-S1, 125.)
~
~
TITI.E
by tow to toke nowledgma+Is is not esse~id to the volidih- of Notice of frde-d Tmc lien G.C,M~,i
Bl~JtJl) ~f ,
PART 3-To be us~d for neordinli pu~pos~s