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Forn, 668 oc~wcr~M oF rne r~wsver~e~ ~uE ~ Fo. opo~ uu er R.oo.d~ otRc.
(REV. 1-70) tQT~w~ ~ ~ ~ T~ ~
C~ISTRKT ~~1~ SERU?L NUMBER
f lE0 ANO RECOR~E~
i hereb~? certify that os 1o the fdbwin¢nomed Mxpayer the ~equire~neots of Section i~. lUC1E COUNTY t~1.
6325(a); lolefnol Revenue Code. have beeo s~isfisd with respeci ro the foxes an?- ROGER POITR?S
. merated below, together with oll statutory udditions provided by Section 6321; ond RECARD YERi~FiEO ~~RT
thot ths lie~ for such taxes and statutory odditions has tF~eby been released. The ~
proper oN'icer in the o1Rce wF~ere notio~ of inlcrnol reve~?ue tax lien was filed on C q py ?
QC~pbAr Q, . 19~j~.. a hereby authorized to rtiake notation FEO ~J 'L ~ 1 ~1 1'
on his books ro~ow tfie ralease of said (ien, ieuof~ as the lien relates to the follow-
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UNPAID BhIMICE )
! KINO OF UX TAX PERIOD ENDED ASSESSMENT DATE IDENTtF1fING NUMBER OF ASSESSMEM`l
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!41 ~-31-?0 T-LD•~ ~i0~.l~?
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WITNESS my Fwnd at i3nlr~snn~ri 7 7 w ~7 nr~d~ , on this,
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ti,e doy of Fnl+rnsr~ , 19~1
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~NOTE: Cert~ficde of ol6cer ued by bw to ~oke acknowledgmenh n nd asent~d to ths vabd~ty of Wot~u of Fedsrd 7oa lren G.C.M.
26~19, C.B. 1950-51, 125
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