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Form 668 U. 5. TREASURY DEPARI'eAENT • iNtEaN~~ rtEVENUE SEewCE ia Opn~a~ Use Br Reco.d ~q Oll~ce
: R EV . 8•671 CERTIfICATE Of RELEASE Of ffDERAI TAX LIEN F~~o ~iECOAaEo
fT.l{iC1E tOUNTr FL~
~ISTRICT SERIAL NO. '
203644 8-189 P--2171 ~OY=~'~~1RAS
CLERlt ~ .CUIi COURT ~
i hereby certify thot as to the (oilowing-named toxpoyer the reQuirements of Sectio~+ p~E~A* ' E~
6325(al, I~ternol Revenue Code, ho~e been sotisfied w~th respect to the toxss e~u- I
meroted belew, together with all stetutory additions p?ovided by Section 6321; and ~L 5'l PM ~~Z
thot the lie~~ for suth toxes and statutory additians hos thereby been reled~sed. The •
pr98 ruoa~cer2j~nn~he of(ice where notice~i inter~ol ~evenue taz lien was (iled on 'J„~~
J y ~ d , 19 is hereby outForized to moke notation ~V~~V
on his books to show the releose of soid lien, insofor as the lien relates to the
following foxes.
NAM.E OF TAXPAYER -
J. i~t~c+i ~ J. lan~
RESIDENCE
=os a. ~rs.
H¦~ns ll~osid~
CLASS OF TAX UNPAID BALANCE
Tox Return Form No.) PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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~'.~l~~ .Ml~Ct11t aYtC T O T A L s 4.~33. Sl
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~ ~;TNESS my hand ot Jacksonville, Florida _ , on ihis,
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~ ,he 12th d~, of December j9 72
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>I ATURE TITLE
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' Ja : Chief, S ecial Procedures Staff
~ tNOTE: Ce ~ca~e oF ofF~tr authwized by (ow ~o take ackno»leagments is not essent~ol to ~!+e raLdity of Nohce o~ Federol Toa Lien G.C.M.
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~ PART ~To be used for recording purposes p
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