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l !1. 5. TREASURY DEFARTMENT •~NTERNAt REVENUE SERViCE
Form 668
(REV. NUV. i961) CERTIFICATE OF RELEASE OF FEDERAL TAX lIEN
(Formerly Form 6691 (To bs w~d fo R~Iras~ Tmc Lbns wntNr S~cfiee? 6325~a), 1.l.C. o} 1954~
; DiSTRICT SERIAL NUMBER
J~ok~Qnville . Florid~ F"I'L8 59. ~~e1~9 _ ~Y~~'~$ ~
i hereby certify thafi as to the following-named taxpayer the requirements of Section 6325(al, internal
Revenue Code of 1954, have been sati~ied with respect to the t~xes enumerated below, together with
' all statutory additions provided by Section 632i; and that the ~ien for such taxes and statutory additions
has thereby been released. The proper offi~er in the otFice where notice of interna! revenue tax lien I
~ was fi1~d on ~rah z~~ , 19-, is hereby authorized to make natatian on his books to show ~
; the re!ease of said lien, insofar as the lien relates to the following taxes.
NAME OF TAXPAYER
_~ad i~~ Br~~ Cnn rac+~r
RESIDE.JCE OR PLACE Of BUSINESS
M ~ e ce lorida
TYPE OF TAX AND PERIUD ATSESSMENT DATE REFERENCE NO. ~~M ~
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~30~62 I2-2r-62 ~9-o73z5o5 2aQ.g~
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~ . . ` POI7RnS. C~ERK
~ : -R@~G~ UC1E C~UNTY, i
i ~ ST. L FLORlDA '
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PLACE OF flliNG ~
Clerk, Circuit Court ~ 2(~''ab ~
TOTAL ;
: St. Lucie Covnty, ~
----Ftz_Pierca_,__Floridn i
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WITt~ESS my hand at______--__ _ J~eksonviile,_ Florida on this,
the__2.-----day of~ ~I~~ 19~'~
- - - - -
D15TRICT DIRECTOR OF IN7ERNl~I REVENUE BY ~Signnture) ~ TL~.
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~t~~~~~ Sectian
F. S. Scbaai.dt I
(NOTE: ~ertificaro of offic~r outhoriaed by 1aw to toke ockrowled ts Is not essential to the validity of thi• 2b419, ~;J~1, 125.~
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PART 3- io be used for raco~ding pur~osn . ~