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~ • F 668 DEPARTMEM Of 1TlE i4E1~SUi[It-~^ITERN/1L REVENUf SERYKE , ~ - Fnr p(~fio~wi Usa By RKOrding OfFice
(R~1•70~~ CQtT~1CATE OF.(t~IEASE OF fED~AI TAX LIEN - ~ _
DIST~ICT - - ~ SER1A1 NlfMBER ~ p ~ H
~ ~ 306149 Bk 238 Page t 8~ t ~p ~ W- `
1 hereb ce~ti that as to the followi~ -named tax er the r uiremenh of Section r~
Y fY 9 R°Y e9 E':.~~:G~1~ ~f .
- 6325(aj, Intemal Revenue Code, have been satisfied with respect ta' the t4xes enu• ~F Y.~ r,t~l ~
merated below, together with all stotutory addifions provided by Section 6321; and ~
fifiat tfie ~ien for such taxes and statutory additions has thereby been released. The
proper f~'ic in 6a office vrhere notice of ' temal revcnue tax lien ~was fi{ed on
~?pr~l ~I ~ ~ 9 ~~js hereb y authoriaed to moke natation _ ~
on his books to show the release of ~said (ien, insofor as the lien relates to the follow- -
' ing iaxa. - ~ - ' .
NAME OF IAXPAYER_ _ : . 3OOa7ais
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~ RESiDENCE - _ _ -
33~ fi 'i'~dr~il+t tMw ~ - . - - -
. - ~ UNPAID_SALANCE
KlND OF TAX TAX PERIOD ENDED ASSESSMENT DATE- ~ IDENTIFYING NUMBER OF ASSESSMENT
(o) {b) (c) _ (dl - - Iel
9~1 06•-34~7~ 1~4'~7ai ~'!~t#~4i9'6 - ~~665~68 - .
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PLACE OF FILING ~ _ ~
. ~ . C'~~ 4'IA~1? ~t . - _ _ ' - ` TOTAL ~ ; ~iiy.bi .
, ~t~ L~~i OQ~'!
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WiTNESS my hond at Jacksonvill~, Ftorida- ,~n tt?;s, '
~e 16th day of May tq 75
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SlGNA7URE _ - TITLE -
~ ~ Jack Durant - Chief; Speciat Procedures St~ff
(NOTE: Certificote of officer 6u i d by o take ocknowledgmentz is not essentiol to the val+dsty of NoSice of Fedeto{ Tax Litn G.C.M.
_ 26419, C.6. 1950-51, 125.) _ - ~~~Ph -
. PART 3-Ta bs used for recon~r~i Py~~ - . -
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