HomeMy WebLinkAbout1867 . ~
~ -
- Fprm 668 DEPARTMENT OF THE TREASURY~ ENTERNAI REVENU: ~iMCE for OplionaJ Use By Record~ng Office •
~REV. i a~ CERT{fICATE Of REIEASE~O~ FEDERAL TAX ~IEN ~ :
~ DISTRICT SERIAL NUMBER ' : RU,.~1U ~t:~~ F~f'Ct~RB~
.lA~S~ONVU.I.E 304835 Bk 237 pg 2981 ~~d~~c~ :~~~r~r ~~t..a. _ W
~ ~i'yin ~''f7~~~~
' 1 hereby certify that os to the following•nomed taxpayer the requirerr;ants o` Section - ;GL~~~ ~„~:3;~111T~.ODtAe~ ~
6325(a); Internal Revenue Code, have been sotisfied wilti respect to the toxes enu- _ Ffr~'~3'? ~__~!~l~p_...~~_ ~
mer~ted below, togetner with all slatutory addiiions provided by Section 6321; ond . ` ~
: tnaF the lien for such taxes and slotu~ory additions has thereby been released. The ~~,y ~~5 W
= prope~arC~i ~ithe of~ice where notice~ pf internol revenue tax lien was filed on _ (r,~ _
; 19 , is heieby authorized to ~ake notation ~np.~r~~ _
on his books to show the release of said lien, insofar as the lien relate~ to the follow- - u~7~~~~ .
ing taxes. - _ ~ -
NAM OF TAXPAYER - ~ ~
~ ~ORS'C~tiC~Of1 CO~i~1 ~ ~s P~~+G-!i I~. ~AC " _
- RESID~~i1;i ~1~ _ ; - _ - :
~ ~~Y'!~!~ ~2 - _ ` _ _
UNPAID BALANCE
KIND OF TAX TAX PERlOD ENOED DATE OF ASS~SSMENT IDENTIFYING NUMBER OF ASSESSMENT
(b) ~d~ (e~ ~
. 941 ~ {~-3~74 1~-23-T4 35~-1~?2382 7~'d96~.~Q -
~ - -
~
- _ -
f
PLACE OF FILING • " _ _
~ ~ ST. 1.l~CiE t~Ul~1~Y ~ _ TOTAL $ T}'~.~,20 .
~ ~ fORT PsERt~. E~t.O~A -
wITNESS .=ny hand at Jacksonville, Florida _ , on this,
the 15th day of May. , 19 7S - . - -
SIGNATURE ~ TIiLE .
J ck Durant Cheif, Special Proc_dures Staff
. (NOTE: Cer ficete ofiicer duthorized by low to take ocknowledgmenfs is not e~sential,to~ ~ of Notice of Fedesat Tox Lien G.C.M. -
26419, C.B. -51, 125.) J`~j _
f.~t~47 ;
- _ . PART 3-To be used for recording pu~poses hd~ ;
~ ~ -
- ~