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Fotm~.~ ~eP~Rmant d_tM Trsasury - Mt~mal Rwenut S~rvico
f~,;.8i~,,,~,t978, . Certi~cate~ of. Retease of Federal Tax Lien
~ ~ Se~ial Number Fo. ovN«ni u.. n~ ~+.~o.akw onrc. • s
543139 Bk 363 Pg 1924 4CT ~ $ ~ ~ ~17 ' '
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i ce~trtt~atastomefaiow~~-~amea~~a~rer. the feci~irements of SeCtion 6325(8) FILE~ ~HC ~c Ci:P^~^
st. c~~cif cci~ r~~: a.
of the Intemal Revenue Code have been ~atisfied for the taxes listed below and ~tCGrR f'Ulr~r;.t; -
for etl statutory edditions. Therefore. the Ilert Provided by COde section 6321 for CLE~:ii CtR(~'~T ci t/ #
f tfiese taxes and additions has been released. l'he Proper officer in ths office ~ . a~Jr1~ _
( ~the notioe of intemal revenue ta~c liee was filed on September Z2 ~
19 81 . is authorized to ~ote the books to show the release of this lien for _
these taxes and additions. s~1~n ~
a~V
Name of Taxpayer . ~
; JMt J. ~ ~1i~1rlit a. 2tI
Residence
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!L.
Unpaid Belance
; Kind of Tax Tax Perbd Ended Date ot Assessment Identi~ting Number of AssessroeM
~ (a3 [b) [cl ld) (s)
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~ L0~0 i~-3~ 06-~-~ t~i.1~ =
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~ Place of Filing
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t Cwert Total = ;t311.ii =
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This certiticate was prepared and signeci at .iacksonville. Florida , on this.
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~ the 13 dayof October ~g $3
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~ Signature 7itle ~
414 p~ 99~
A.W. SENDLER CHIEF ADVISO
~ Mar. ce.r~r~care or on~cer authaized cy raw ro ake acimowredymPrns rs na ssssnr~.i ro ~ne v.~;duy a Narce a
~ Federal Tax Lien li.C.M. 1N19. 19541. C.B_ 125.)
~ Patt 3- To be used for tecording purposes yt Form ~68 (Ftev. 9-78)
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