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Fam g~ O~p~rtment of lM ~rusury - Ints~ns~ Rev~~ue Sen~ce
;Rev. July 1987) Certificate of Release of Federal Tax Lien
Districi Serial Number ForOptiona! Uae by Recwding ON:ce
Ft Lauder ale Florida 58811766
OR Book 574
~ certify that as to tAe following-named taxpayer, the rsquirements ot section 6325(a~ of the OR Page 2187
lnternai iievenue Code have been sat+sfied for the taxes listed below and fo? all staiutory
additiOna Thlretore, the lien provided by Code section 6321 for these taxes and additions has
been reteasod. The proper officer in the office where the notiCe of internal revenue tax lien was
fiied on F e 1 ~ 19__~~ is authorized to note ti~e books to show the release of thPs lien ~
for theee tax~s and additiona Rec F~ e S
DOUGLd~.g DtXON
t~ams of taxpay~ ~ Lucie Coetnl~r
! Doc Tar_ 3 Quk of Cin:vit Co~ut
~ Michael E. Marcia Provencher fn~ 1'~ i ~g~,
Residencs
582 Avens St. N.W. T~= ~tyClerk
Pt. St. Lucie FL ~4983-8657
~
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~ Tax Period Date oi Last Day for Unpaid Balance
i Kind of Tax Ended identifying Number Assessma~t Refiling of Assessment I
f r•~ ro~ r~i ra~ rN m ,
f
; 1040 12/31/85 003-42-8626 02/16/87 03/18/93 1,93$.35
~ 1040 12/31/86 " 06/O1/87 07/O1/93 823.00
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Clerk of the Circuit Court Tota~ s 2~761.35
St. Lucie County Courthouse
Ft. Pierce, FL 34950
i n~s certificate was prepared and signed at F t_ Pi Pr~_P 9 F l nri c~a onthis,
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~ ~ne 29 t y ot J n~ar ,~y 90
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s Signature TiUe
/~6r John Anderson Group Manager
( Ce ficate of officer auihorired by law to take acknowladgemen[s is nof e~sential to the velidity of Notioe of Federal
ax Lien R v. Rul. 71-466, t97t-2 C.B. 409.)
Part3-Tobeusedforrecordin Pur oaes ar;~r~~5 PACE~Q~~ FO""~i~"'e'i
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