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Form 668 DE?AtiMENT OF 1ME TfEA511R1l-~ITER1iAl RfVENUE SERVICE ~ . Fa Op~o~wl U,. er Reoordug
' 1~EV. 1-7Q} ' ~ ~ T~ ~
DISTRiCT SERIAL NUMBER ~ - ~~~~p~~~~ "
!LM'!i 212 08 19l~-1~97 p,~ q~lt plMt
1 hereby cefify that os to the foliowing-named roxpayer the requirements of Section ~LOM ~F~1
6325~0}, Irtternal Revenue Code, have been sa6sfied with respett to the taxes a~u-
meroMd below, together with oll stotutory odditions pravided by Secfion 6321; and
; thot ihe lien for such taxes and stoturory odditions has thereby been releosed. The
~ proper oRxer in the oii'?ce where notice of inlernal revenue tax lien wos 61ed on _
~ _~Zy 22a , 191~., is hereby authorized to diake ~otation
on his books to show the release of soid I~en, inwfor os the lien retotes to the follow- ~4939
ing toxes.
NAME Of TAXPAYER -
~L/ ~A~
RESIDENCE ~ ~~s. sN~
!re't tl+t+N~ tLt~•j~~
UNP/11D BALMKE
l qND OF TAX TAX PERIOD ENDED ASSESSMENT ~ATE IDENTIFYING NUMBER OF /\SSESSMENT
~ lal rol ~k1 ldl te1
j ~ l1~i 3-~-7~ 6-3~-71 ` 9!-e!~'Sm
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~ PUCE OF HUNG - ~i~
~ ~ L~~i TOTAI s
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v~nTNE55 n?r hond m Jack~onville, Floric~a , on Mu,
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~ d00K _ PAGE .
S~GNATURE ~ MLE
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(NO?E: C d o(1'K~r outhausd bp law to toke acknowledprne~rs a ~d essennd ro rM vol~d~r of Nonu oi ivd«d Tax l~.n G.C.M
26119, C. . 1950-51, 125.)
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PART 3-To b~ us~d fw .ecordin0 pv~pos~s
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