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HomeMy WebLinkAbout2961 ~ ~ . - - - - - - . _ : . ~ . . ~ • Wa7~~ FOfm 668 DEPARTMENT OF THE TRf/l5U(~f--#V1fRNAl EEVENUE 5ERYKE _ • For Optionci U~s 8y R~cnrdng OlRts . -(REK 1-70) ~ CERT~IGTF Qf REtEASE OF ~08tAL TAX LIE~! , - s~~`~`U ~U Y _ DlSTt~C?•. ; ~ SERIAL NUMBER . , 4g~~; ~,N~T Ft~A• . J 298938 Bk 235 P+~ga 1027' - ClF ;K C' 3~.~~t' Qo JR~ - 1 hereby certify that as to the fallowing-named taxpayer ifie_requiremenh of Section- R~~~~~~ ~r°'~`te~'*""""" 6325(a), Internal Revenue Code, hove been sotisfied with respect to N~e taxes e~u- ~ pu ~ - ~ merated bebw, togetfier with oll statutory additions p~ovided by Section 6321; ond M~~__~~ ~2 1~ 1 rl ' tttat the Jien for such taxes and statutory additioru hos thereby been ~eleased. The ~ " pro~+er ~o ice ~ where notice ~ internal revenue tax tien was filed on e~~~C P~ , 19 ~s, is hereby authorized to make notation V , on his books-#o show the release of said lien, insofar as the lien relates to the follow- ~ _ - ing taxes. _ _ - NAME OF TAXPAYER . - - _ - . , ~ - 1~ilt~~ L. i i1~'S~s ~ ~ - ~ - - RESIDENCE - ~ - _ P.O. DOS ~ . _ - _ ~ z _ ' - _ - ~ UNPAID BAI.AR~~E - KIND OF TAX TAX PERIOD ENDED ASSESSM~NT DATE ~ IDENTIFYING NUMBER ~ OF ASSESSMENT - (a) - (b) ~ - (cj (d1 - (e) ~ . ~ . , _ . ~ . _ . - - _ _ . . ~ PLACE OF FILING - - - - , - Cfoxk~ C~tXt~t ~4ti~t _ .TOTAL ; - _ ~ _ . st. luc.~ Coue~ty - ' ?6i~.~1? ~ - . ~ Fat P~e+~ca. ~lo~da - . - - . . - r, - . . - ~ - ~ . ~ " _ _ ~ . , ~ _ WI'M ~ my hand at Jaclc.~nvt111e7-.Flos~l,da , ~ , on this, ~ ' - . - - - ~ . _ _ , ~ _ . _ 3 _ = the 23 day of ~Y ` , 19 75 ~ - ; SIGNATUR - - ~ _ TITLE . : l~1 p~ ~ - , ck Duri~~E~ Chief, 3prcial Procadures Staff _ (NOTE: Certificate of officer outhorized by law to toke ocknowledgmenFs is not essentiat to fhe voliddy of Notice of Federol Taoc L'~ep G.C_M. 26419, t.B. 1950-St, 125.) ' 0 R r~c~~ d ~ - 600Qt r.tii7 P116E~~i~ ~ ~ - ~ - . PART 3---To ba _us~d for rocordir~ Purpo'~ - ~ . G . ' ' - . . _ : . . - _