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t1fPARil~IfNT Ui iNE TREA~iia`1 - UfifRtiAl RtliF~ii)f SE~f fw OPtiana! Use By RtCadirn
iaEV i~i~~ CERTIFICA7E OF RELEASE OF FEDERAL TAX LIEN ~.~~rO
DISTRICT SERIAL NUMBEFi
~ 415637 bk-293 -1397
I hereby certify that as to the followmg-named taxpayer the reqwrements of section 7
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63251el. Internal Revenue Code. have been satisfied with respect to the taxes enu- ~
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merated below. together with all statutory addition~ provided by section 6321: and
that the I~en tor such taxes and statutory additions has thereby been released. The
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ake notation
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on Lhe books to show the release of said i~en. msofar as the lien relates to the follow- `
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ing taxes. - ~
NAME OF TAXPAYER
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~Mi~ it~al~la~ ar~eae~!
RESIDENCE
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KIND OF TAX
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TAX PERiOD ENDED
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OATE OF ASSESSMENT
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IDENTIFYtNG NUMBER
Idl UNPAID BAUNCE
OF ASSESSMENT
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44I 0~-~0-77 1?-19-T1 " 1~~~
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PLACE OF FILING (`,~ ~ (`,#s~!= ~~,
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WITNESS my hand at Jacksonville~ Fla.
the 17th day of March ~g 81
SIGNATURE • TITLE
Van E, ~'Nea1V ~~~ . Chief~ Special Procedures Staff
INOTE Gertd~caro o~ o~hr_er auchor~red Dy +aw to take arkru~wledgmentc ~s not essenual to the vabdrtv o1 Nouce of federal Ta: t-en G C M
2&41?. C 8 1950~ !. 12 5 1 dt
PART 6- To be used for recording purposes a~l~1!(~v1 ~'~~~ ~~
on this.
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