HomeMy WebLinkAbout2768 Fof~n 668 OEPARiMENT O~ iHE T~E~SI.[Y-\atEWnl REYENJE SERYKE for OWcral U~t S1 Recordng ON~ice
~r~v. i.~oy CERTWUTE OF RELEASE Oi FEOERAI TAX t1EN
FilEO ANU RECORp~~
DISTRICT SERiAi. NUMBER ST.ttICIE COqMTY fL~
~ a $1`.? P26~ 1 ROCERPOiTRAS Mc~
1 hereby certify thot as to the followirg-named ~oxpoye~ the requiremenfs of Section CIERi~ CIRCUIT COII~T
632J(a), Internul Revenue Code, have been sofisfied with respect to the toxes enu- RECORD YERIilEO`~
merated below, togeTher with all stotutory additions provided by $ection 6321; and ~ ~ 9 9 s9 ~M •T ~
thot the lien for such toxes and statutory odditions has thereby bee~ rcleased. The
proper ofRcer in the ofi'ice where notice of internol revenue tox lien was fiieci on
ianL~- 2~ , 19~1_. is heroby outhorized to diake ra`otio~
0o his books to show the release of soid lien, insofor as the lien relata to the follow-
ing taxet.
NAME OF T/1XPAYER
Ci~ Y ~s~'~K
RESIDENCE
l1L0 N~~ 0
~et ~ea ~ellr ~1~
- uNPa~ e~u~vcE
' KIND Of TAX TAX PERfO~ ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF AS,SESSMENT
(o~ (bl Icl Idl (~l
,
` 941 Kt1~i~I~ti~ 0l•~7i 1i~11~70 S~7lZSOS i ta~•a
~
~
{
f
~
5
~
A.
~i
PtACE OF FIIING
~
~ ~ ~'Ow!! ' TOTAL s i~~~~ ~
~ ~w.~ ti.~.~ ~s...al.
;e
~
~ :.;~+vE$S my hand af 'ae~sn~~~yl'•t3 ~riri~ , on thii,
~ ~
~
~
~
F ~~n `_~;_day of :•s~~_. 1~~ -
~
~
~
; - -
~ ~ :,r~ATUQ - TiTIE i~ z~s~
~ r_ } ~ ~}'1.~~:~,~ :~;r~'1G1 ~1'xQ~~TBS ~t'~~_~--
_~r• 'rnfc .re uf off,ce. av~n~r,ied b~ +;.w ~e tule o~k~K~~r?edymer~K is nr_+ r.sen!~ol to the vaLd:ly of Nut~ce of federal Tu. l~e~ G C M
~ ,
~ l51il.~B i9:Ci-51. 12i1
~ ~S
PART 3-To b~ us~d fw ~ecordin~ purpos~s
~
~
~ _ - - :r - - s_. - . _ .