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Form 668 OEP/JtTMEt~If OF THE TlFJ1A/Ri-~1TERNAI REYEIn~7E SERVKE r-o. Opr~a,o1 u,e sr Reco.dr~ OJ~ce
~~v ~.~o~ CERTI~ICATE 0~ REIEASf QF fEDERAI IAX l1EN s.L IE COU
DISTRICT SERIAL NUMBER CLERk~ClRCU T C01Rt
_ 206 0 B P 7 RECOAO YERIf1E0....~..,~.~
I heret~y certify that os to the foliowingnamed taxpayer the requirements of Section
6325(a~, Internol itevenue Code, hove been safisFied with :espect to the taxes enu- + 1
merated be~ow, together with ail statutory additions provided by Section 6321; and + ~~~p~
that ths lien fa such taxes ond sratubry additions has thereby bee~ releosed. The ~a~~~~~7V
proper of~'icer in the of~'ice where notice of internal revenue tax lien wos nled on } ~
March 23 , 19~L, is hereby outhorized to rsioke notation /t~ Y~~N~~~
on his books to show the releose of wid lie~, iosofar us the lien relates to the follow-
ing tazes.
NAME OF UXPAYER
l~l tM_ ~3i~r
RESIDENCE
~ ~ ~ ~ '
!~!'fi tll~~ Y7ro~3~lt - -
uNpa~ e~uNCE
KIND OF UX TAX PERlOD ENDED ASSESSMENT DATE IDENiIFYING NUMBER OF ASSESSMENT
~ tal t~l kl (d1 lei
; l~di~ 1~3~1 13~~7~ ~ ~
I L0~ 1.2~~ 7,3~+'~0
I
~
~ PLACE OF FIUNG Q~~ ~s~; ~,t
a~ ~ 1OTAl S
~ Toet l1~~ t1~a
~
~ wlTivESS my hond at Jacksonville, Florid~ , on th~s,
~
the 9th ~y of u , 19 7 -
SIGNA „r t~ -
~ ~
G~ N. sselw
(NOTE: Certificate of o ovthorized by law to toke acknowled9menls is not essential to the volidity of Notice of Federd Tme tien G.C.M
26l19, C.B. 1950-51, 125.~
PART 3-To b~ vsed for ncordin~ PeRoses ~Q~~~~ ~A~~ ,
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