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Eorm 668 oerur~?+r oF t~ Tq~uer-r~r~en~ s~wce . For Oa;«ar u,. sr e.oo.ane OIFc.
(REV. 1=701 ~~u~ ~ ff~~ T~ ~ i
DISTRICT " SERUIL NUMBER . ~
241142 8207 P2~i90 ~ ~ p
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t here~r terlify Nwt as to the following~na taxpaYer the requiremenls o sect;on lE~ E~ ~
6325(a~, lnternol Revenue Code, have been satisfied with respect to the taxes enu- C~tya
merofed below, together with all stotutory odd?ions provided by Section 6321; and ~E~~~D ~~~.~¦.~w.r~,r.
that ths lien for such taxes ond statutory odditiau hus ttiereby been reteased. The ' -
pwper oific~ in the q,H'ice where rrotics iMerne) revcnue tax lien wos Bled on
Novembe= 1~ , 1 q ~ is hereby outhorized to r~ke notation - ~
o~ his books M show the release of wid lien, insofar os the lien relates b the foftow-
ing tmtes.
NAME OF TAXPAYER r~~~~''~'~
. - ~G~`~v~~ -
M~a ~ it 1~ ~ ~r~¦M _ _ ~ '
RESIDENCE
S~~ ~ ~fa ~t ~ .
11~et !l~ra+M, 1?~ ~149~
. tnvPa~ ~~w~E
KIND OF TAX TiU( PER10D ENDED ASSESSMENT DATE IDENTtFYING NUMBER OF ASSESSMENT
to) {~l t~l (dl !e1
UM t?~•31•Tt ~i•sl•Tt i7ir14
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I P1ACE OF flUNG
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WITNESS my hand at Jackeoaville. Florida , on this,
E 19th March 73
+he dar of , 19 :
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i
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TURE 71T1E
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ack r hief ~S c1a1 Procedurea Stsff
( : Certi6cvM of oN'icer outhaized by low ro roke ackrwwiedgmer+fs is nw essent+al b the vd;d;yr of Nofice of f~dard Tax lien G.C.AA.
bI19, C.B. 1950-S1, 125.)
PART 3-To b~ vs~d for ncordjnp purposts s e