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~ F~ , Depert+nertt of the Treaaury - Intvmal Rwenue Service
(Rev $eptember1978) Certificate of Release of Federai Tax Lien
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J~~~~• S9ri'81 Nurt1b@r Fw OpHona/ Us~ Oy Racordlnp OHics
( 473036 Bk 324 PG 53 ~ 4CY A~ 9' G7
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; I cefify that as to the foliowing-named taxpayer. the requirements o# section 6325(a) cit E C~~c F! ~~:r:'=
of the Intemal Revenue Code have been satisfied for the taxes listed below and 51. tt~+:~E f~~,~; ~
I for aii statutory additions. Therefore. the lien pravided by C.ode section 6321 for "~rR'~~~
, CLE=K Ci-C::1:
these taxes and additions has been relea~ed. The proper officer in the office .
~ wherQ the notice of intemal revenue tax lien was ~led on Jan 17 ~ -
19~_. is authorized to note the books to show the release of this lien for ,
E these taxes and aciditions.
Name of Taxpayer JM D~t i D~ti1~ i. h~ils
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~ tia~ 3ti. Lro~. ~3~adds ~~T
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( Unpaid Balance
Kind of Tax Tax Period Ended Date of Assassment Identffyin~ Number of A~ssment
W (D) (C) (d) (e)
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! ; 1~0+10 f2y-~-?~ a4'-i~~9'9 ~6r'l~-7d-~960 . ~.38 <
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i Place of Filing Cl~ Ci~t ~it
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= 8t, L~d.~ Q~aal,~ t'.Altleo~i~ Total = l.~S•~
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; This certificate was prepared and signed at Jacksonvil le, Florida ~~~is~
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~ the 30th ~ypf September~~g 83
~ Signature Title
~ A. W. Se Chtef, Advisory Unita~~4
(Na~c c..rnrc.a a onk.. .urno.~.a br wM ro ak• .e~nowr.ay~n.ras ~s nor .s..orw ro a~. +?a~wrh a Nonc~ a '
~ Fso..s~ rax ~ o.c.~. ze~~o ~asa~. c.e. ~za.) ccc 9/30/83 rg . ~
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~ Part 3- To be used for rec~~dirp purposes Form a68 (Rev. 5~78)
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