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~ Form 668 ' oE rMfMr of tNE A~wSt![+I-1+fFeN/~t eEVENUE SE~VICE , Fo. Op~onal U,e 8y Recadu~ OIFce
(~v 1-70~ C~T~IUTE OF ~ASE Of fED~AL TAX l~i
DISTRKT SERIAL NUMBER ~
I herebr certifp that as ro the folbwing-nemed taxpoyer the requiremer~h of Section ~w
6325~0), Inten?ol itevenue Code. have been sotisf'ied with respect to the laxes enu-
merated below, together with all statutory oddifions provided by Sec:lion 6321; and
' thot the lien for such roxes and stotuMt)? adddions hos tl~eby been released. The
proper office~ in the o(Fice where notic~ of infemd revenue tax liert wos filed on
~ _A~ teber 21 , 19~9._, is herebp authorized to rriake notation
on his books to show the rdeose of soid !'ien, insofo~ os the lien relota ro the follow- ~,t
iog taxes.
MAME OF UXPAYER •
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RE5IDENCE ~ ~a .~i•
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UNPAID BAUNCE
~i KIND OF TAX TAX PERIOD ENDED ASSESSINENT DATE I~ENTIFYING NWNBER OF ASSESSMENT
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~ PLACE OF FIUNG
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~ `~NITNESS my hond at _s~k nn 71~_$1,p~da , on th~s,
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+he ~_doy of_~rr_h , 19~1
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- S:GW?TURE TITIE
_ k D Chie , S~eoial Procadurea Staff
INO Cv~~bcot~ of oPficrr nuthonred by ~ow to ~oke ocknowledymeMS n nd essent~ol lo ~tr vohd~ry o! No~~ce of fecfeial T~r Lan G C M.
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-~a ?GI19, C.B. 1950-51, 12; )
PART 3-To b~ w~d fw r~cordin~ pury~os~s 80GK~~ ~;r~7°!(7
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