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HomeMy WebLinkAbout1554 I . ~ , _ _ _ _ . . . . FOfm 668 DEPAitTMENT Cr~= THE TZi E~SUftY~ITERNAL REVENUE SEiMCE ~ For Opfionol Use By Recording O/fice _ ~ ~REV. ~ a~ i ~ . CERTIHCATE:Of Rfl,EASE:_4F FEDERAL TAlE-1tEN _ - ' - - - . DISTRfCT - SERIAL NUMBER ~ ~ ~ _ . - : 301649 B236 P 159b > ~ : ~ ~~~p•., I hereby certify thoYas to the following-ndmed toxpoyer the requirements of Section ~ v! ~325(a~;~ Intemal Revenue Code, have been`ipfisfied with respect to the taxes e~u- . merated,below, together with all statutory additian; provided by Seciion 6321; ond : ~ that the lien for such taxes and statutory addition3. has the~eby been reledsed.; The ~ prop fficer in th ofiice where ~notice f iritemaf revenue tax tien was filed_ on ~ _ ~l~1 ualcy 1~ , ~ 9 7~ R~e6y authorized b niake notation - - - ~ on his books to show the release o f sai d lien, iriso far as t he lien re iates fo t he fo l low- - ~ ing taxes. . , _ _ - . - . - - - - _ _ NAME OF TAXPAYER . , - ~i . _ - _ - - - - - _ _ _ _ ~~r ~ - RESIQENCE _ _ . - - _ - ~ P3~[ - - _ _ ~~s F~. 33~2 ~ _ : • ~ ~ - _ ~ - - UNPAID BALANCE - KIND OF TAX TAX PERIOD ENDED. DATE OF ASSESSMENT IDENTIFYI~lG NUMBER OF ASSESSMfNT - (a1 (~1 - ld~ ' te1 _ 9~1 ~-33- ~T3 : U9-3a•?4 ',~-~~90"t34 3~467• s~ ` - - 941 - 3~?~-7# ~~2~3•?~`3 " ~ ?~6~3.34 - 942 9~?3a»T# ~-~3-"I# . " _ ~3~~ . - FtLED .'.1+p ~~COAOED ~ . Si. LUCIE LOUNIY ~lA. _ - ~ RUCF.^- : ~11tRAS ~ _ - - _ - CLEhK C!n~,~.fl~ COURT . ~ - - RF/;Gii~' VERt~iE@ _ , MkY 15 ~2 19,~~'-~~J - _ . - _ . _ - ~ - : PL/~CE OF FlLING . ` _ L~lC3~ ~ ' . FO~iT PlERCr. Fi~O~A - ~ TOTAL S ~'i~3•?9 - . ~ - 1 - - ~ ~ . ~ _ ~ . ~ - - - _ ~ - d WITNESS my hand ar .Iackaonvflle ~ Flarfda - - ~ _ , on this, ' - S _ the 13th day o# ~y , 1 ~ 75 ~ - - - . - - . SIGNATURE - - . - _ _ T1TLE " ' ~ ck D~rant Chief, Special Procedures $taff , (NOTr: Certificot of o cer outhorized Ey. low to toke acknowledgmenfs i, not essential tojh~validi of Notice of Federot Tox ti2~ G.C.M. ?6419, C.B. 195 -51 25.) ` . 8001(~,~ ~~V~i - ~ F'ART 3-7n be used for recording purpeses , sr - - - . _ _ . j t - t