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Form 668 oev~r?,~rrr oF n+E n~~stMr-avrEQruu teveNUE setvrCe Fo. OW~o~wl Ua M~~^9
s ~eEk ~-~o~ tERTIRUTE OF ~IEASE Of FEDBtAt TAX IIEN F lE0 ANO p~p~
k DISTRICT SERIAL NUMBER UCIE C~ tY F1A.
JACKSONVILLE TLORIDA OR Book 181; Page 2332 ~E~KC~~~~ a~T ~
? 1 herebY certify that as ~o the following-namsd taxpayer the requirements of Section ItEC0A0 YERIF 0~
Y 6325(a). Inbrnol Revenue Code, have been sotisfied with respect to fhe toxes enu- ~
merated below, together with ail statutory odditions provided by Section 6321; und ~j' g T'
3 that the lien for such tnxes and statutory oddifions has thereby been releosed. The ~
` prope~ of~'icer in the of~'ic4 wher notice miernal re~ver?ue tox lien was filed o~
December ~8 ~ ~9 is hereby authorized to make notation
" on his books ro show the release of said lien, insofar os the lien rolates to ths folbw-
= i~g taxes.
- NAME OF UXPAYER
Daniel D. b Carol }tunt
RESIDENCE
1109 Angle Road
- Fort Pierce Florida 33450
UNP/11D BALANCE
- K1ND OF TAX TAX PERIOLI ENDED ASSESSMENT DATE IDENTIfYING NtJAABER OF ASSESSMENT
ia~ roi c~~ cd~ ~e~
tis
=r 1040 Incaae 12-31-68 OS-30-69 240-56-3084 $ 912.76
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Pt~1CE OF F!lIMG
Clerk, ~ircuit Court
St. lucie County TOTAL S 912.76
- Fort Pierce, Florida
w1TNESS my hand or West Palm Beach~ Florida , o~
~
the_~th day af October, ~q 71
- .
_ - Qij~.,~ ~nK~~ - -
SIGNA~uR~'~~~~`~ ! ~ TITLE
~ ~
~ v THOMAS C. GRAVES GROIJP SUP£RVI90R ACTS
- ;hOTE: Cr,t~fcate of oR'~ce~ au~ho~ zPd by faw to ta<e ocknow;edgments n not essentiol to +he vai~d~y of Notice of Federol Tax t~en G.C_M.
- ?6d l9, C.B. 1950-51, i 25.)
= PART 3-To bo used for recordin~ purpos~s
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