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~ Form 668 ap~un~r'oF tt+~ reF~nr-a~r?E~u eEVx+ue ~ rw qpe~ond th. ey Reco.dey olfc.
(AEY. 1-70~ (~~ATE ~ ~ ~~A~ T~ ~1 : CI C
DlSiRICT . SERIAL NUMBER ~ ~t 4Ea~ PGtt .
231986 B203 P1796 CtERK CtRCUt
, I hereby certify ihat os ro the following-nomed Maxpoyer the requiremenls of Sedion ~CORO~vEtt~itE~ _
~ 6325(a), Int~emol Revenue Code, have been tatisfied with respe<.t to the toxes aeu- t ~
merated •below, together with all statutory odd+tio~s provided by Section 6321; ~d
thot the lien for wch toxes ond srohrtory additions hos tl~eby beer? released. The
~ i oH'ioe wherenot,~e_ f iniernal revenue tox lien was filed on N~ J. ~ 8 Il : 13
u e~3;- 2$~ , 19 7~ ~ is heroby avthorized b make notation ,~~~.y
, on his books ro show the release of said lisn, i~ofar as ths lien relotes to the fdbw- ~~?~~1Gr
~ ~ng tmces, -
1dAAAE OF T/1XPAYBt
RESIDENCE
21~os ,~.r... s
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INVP/UD B~AIANCE
IClND OF U1X TAX PER10D END~ AS,SESSMH~T DATE IDENTlFYING NUMBER OF ASSESSMENT
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~ !~3 ~toa 1i-11•~l oi•0~•7! !'l~~i~164 = ~.~i
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WITNESS my hand at Jacksonville, Florida , on this,
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the 22nd doy of November , 19 72
SIGNAT 71TlE
Jac rant ' Chief, Special Procedures Staff
~ : Certificote of off'icer a~tFwrized by law to taRe ocknowledgments is not essentiol to the volidifp of Notice of Fecleral Tax Liee G.C.M.
26419, C.B. 1950-S1, 125.)
, ~0~'* 7 ~AI..E PART 3-To be used for recordin~ purpos~s ra
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