HomeMy WebLinkAbout1869 . . ~ a . . . . . ~ _ _
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Fo~m 668 - . - DEPARTMENT OP THE iREASURY-IIhTERNAl. RPJENUE SfRVICE . ionof Use By_ Recard;ng OfFKe
~REV. i an ~ CE~tTIf1CATE Of RELEASE Of fEDE1tAl. TAX ~EN - r~~, -
~Gf., s FOt
_ DISTRICT ,~~Y'~ SERIAL NUMBER tRl~S
El ft~R r,t ?CtllT C4URT
_ 29~659 Bk 233 P$ 1175 Rf 4;~:~ ~ y~ p; rjCn '
' I hereby certify that as to the following-na~ed taxpayer the requirements of Section - : _
l~325(a},` intemol Revenue Coc1e, have been `satisfied wilh respecl to 1he_ taxes enu- J~ ` p
meroteil below,_ together wilh all stalutoiy additions provided by Section b321; and S4 1~
that thb~lien for such taxes and statutory addi~ions has thereby been released. The . ~ , •
prope~oOVC~r in ihe office where notice~,~f internul revenue tQx (ien was filed on : ~
, 19 , is hereby authorized to r~iake notation
. on his boolcs to show the re~ease of said lien, insofor as the lien relates to the foflow- ~5 -
i~g taxes. - -
NAME OF TAXPAYER . - ~
{i5 . - .
RESIDENCE _ - _ . . -
~3~t471~A _ - _
Pt. .Pie~`~~ ~ 33~E32 - _ _
. UNPAID 3ALANCE ~
KIND OF~TAX TAX PERIOD ENDED DATE OF ASSESSMEyT IDENTIhYING NUMBER OF ASSESSMENT
~a) (b) (c) (dj . (e)
94~ (33-31-74 t3'7-~QQ-74 . 59~-141~253 _ ~~97F3.6b
- `~41 Q6-3C~y4 x~'~?4 59~~~}1~~ - " 4! 232 ~ 82
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.
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PLACE OF FILING -
~ - $~1~. ial~l~ ~y'Y - - -
I ~ ~ ~ TOTAI $ ~f~1~47 -
WITNESS my hand at Jacksonville, Florida ~ ~
, on this,
. i_
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" . . . . . ' . . S
, t '
the 14th day of MaY 19 ~S ~ _
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SIGNATURE ~ T1TLE
- anE~~~ Chief, S cial Procedures Staff f
(NOTE: Certificate of cer thorized by law to toke ocknowledgments is nof essentiol to the volidity of Notice of Federol Tox l"sen G.C.M. '
26419, C.B. 1950-51, 1 . ~ ~
~o~ ~~.~5i ~
PART 3-Yo be used for recording purpose hds ~
a