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Fene 6681 U. S TItEASURY DEPARTMENT - It~TEF•.~~ REvEHUE SE~v~CE F,~ G~pr,oncl'Jst f~ Recad~nq O~~~ce
~ev. a-s~~~ CERTIFICATE ~ REIEASE Oi fEDERAI TAX UEN
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DISTRICT SERIAL NO. ~ '
Jaakao~l]~t~ ~l+i~ ~ 1907~~; E183 P1o65 ~v~~~ ~
1 hereby c~~tify thot as to the (oliow~ng-nam~d toxpoyer the reQuirem~~ts of Sect~o~ ' •
6325(a), int~rnal Revenue Code, have be~~ sotisfisd w~tF respect to the te:es enu-
m~roted bslc+v, toyethe. with oli stotutorr addifions prov~ded by Section" 6321; ond ~
thot the lien For such to:es ond stotutay odditians Iws thereby been releesed. Th~ FEg 2 A•M•
proper olficer in the ofFice where no?ice of internel reve~ue tox lie~ wos f:led on
M8r -h , 19~Q _ is F~ereby authui:ed to rnoke notot~on .
on 6is books to show the ~elecse of said lien,_insofor as the li~n ~elotes to the 223140
follow~nq ta:~s.
NAME OF TAXPAYER
~t~~
RESIDENCE
l~~ ~ ~5T! t3i~•33~'~
CLASS OF TAX UNPAID BALANCE
' t,Tox Return Fo~m No.) PERtOD ENDED ASSESSMENT DATE ID[~1TtFY.ING NUMBER OF A55 :SSMENT
~ (o) ~b). (c) (d1 ie)
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' ldyp 12-31-68 9-5-b! ~7'00 a60.t3
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PLACE OF FIUNG Cli~~~ C~i; ~
L~ C~~ TOTAL 5
~ r~ P~~aM~ ~L~•33~
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~v WITNESS my hand at on this,.
wr the~Zt.h_day of Jarn~arv ,19 7~'
SIGNATURE TITLE ~
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x,
Jack flur Qiief, 9pecial Procedurea Staff
: Cer~Hi of offic~r ov~ :ed br low to toke ockno..ledq~nen~s ~s no~ ess~nt;ol ro ~he ~ol~dcrr of Na~c• o~ F~~wl To~ L~ ~r G.CJ~A.
26119, C 95a51, 1ZS.)
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PART 3-To b~ used for recording purposes
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