HomeMy WebLinkAbout0821 r, ~ ~ _ _ _ ; - - _ _ ' '
form 668 oEVNtTMErIT OF n1E TRFwwirr-MItEa~lAt uE SEev~CE For Op?io~wl (he ~ Reco.dnD Oflic~
(REV. 1-70) ~Q~u~ ~ R~~ ~ ~
DISTRICT . SERWL NUAABER `~.J i~~{~OI~~O~~T~
, 220698 d198 P31S CE4 P~ITRAf
1 he~eby ceitify fhat os to the following-~amed toxpayer the requiremenls of Section R~QOR9RVEklij~p ~~uRT
, 6325(a), Internol Revenue Code, hove bcen satisfied with respect to the toxes eou-
merote~ below, together with all statutory odditions provided by S~ction 6321; and 1u., f~ 'O ~8
tlwt tfia lien for such toXes a~,d srorurory addtions has ~he~ebr been released. The tl~11
proper o~ficer in the office where noti of inlernal oe~renue tox lien was 61ed on
DeC~~blr 17,, , 1~~, a herebr authorized to ~oke nototion 2.313i8
on his books to show M~e release of said (ien, inwfar as the lien relates to the folbw-
ing toxef.
NMAE OF TAXPAYER
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r~~~Er~cE D i D tLL i~~~rr~ Oa.
P. tL DAt ~
UNPAI~ BIILMKE
1UNp pF UX TAX tER10D ENDED ASSESSIiAENT DATE IDENTIFYING N111NBER OF ASSESSAAENT
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~ PIACE OF HUNG
C,terk. C~rcu~t GOwt TOTAL S=.~'~,.~
~ St L~c Cour~ty
Fwt P+erca: FlOrsds
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, on this,
WITNESS my hand ot Jacksonville F1Q ida
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~ the 7th ~y of June , 19 72 g~(~:L1J PAGE ~
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SIGN TURE - TITL
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~ L Cbi~f, Special Proc~durs~ Staff
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TE: Cer ate of officer outhorized by iaw to toke ocknowledgments ~s not essent~al to the vol~dity of Nohce of feduol Toz iien G_C.M.
26~19, . . 1950-51, 125.)
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~ PART 3-To ba used for recordi~y purpo;es
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