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~ Ferm 668 U. S. TREASURY pEPARTMEPtT - iHrERv~~ rtEVEKUE SE~v~CE I Fw Ca:.v.cf U~s B~ Reco.d.ny Oll~ce
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(REV. 8-47i CERt1FiCATE ~OF REIEASE OF fFD~RAI TAX UEN ~
! DISTRICT . : SERIAL NO. ~ N
~ J 251986 B fIlEO AN9 R~~oR~ `
j 1 hereb_ certify thut oa lo the lollowing-nomtd toxpoyer the raquiremeots of Sectioo =T•1~1~'il~ ~0 r
~ 6325(01, interool Rev~nue Cod~, Iwve be~n sotis~ied w~th respec~ to the tox~s cnu- ROQ:R ~OS7RAS
' meroted betc«, togtth~• with oli stotutwy addit+ons prov~ded b Section 6321; end C~ERR Li~:CU17 CO~RT ~
~ that the lien for svch toxes artd statutoey odditians hos ~herebyYbeen relecsed. The RFCOR~'1 VE~~ftEO~~...~~
• proper o(fic~r in the office where notice of interool revenue tox lien was E:led on
~n=il 13~ , ~9~, ~s heredy outhorised to moke notctior? ~~'O II 49 AN
i on his books to show the releose of said (ien. inso(or as the lien relotes to ths
followinq Mx~s. ~ ~e~l"~ '
NAME OF TAXPAYER
; Tiltri~ll~'Qr ~1'~1 .~+QA ~
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; RESIDENCE ~O ~ •
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; C1A55 OF TAX UNPAID BALANCE
(Tox Return Fwm tJo.) PERIOD ENDED ASSESSMENT DATE IDc~.TlFYING NUMBER OF ASS=SSMENT
t (o) ~b) (c) (d) ~s)
; 9W3. IC 06••30•6q 02-23•?3 59-OA6ti19~ 84~6.08
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j~~ ~j{~ ~ TOTAL S ~~Og
' ~ ~~~0, ~~;A 3.s~?v .
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~ WITNESS my hand at Jiclcsnnvill~~ Flnrida on this
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i rhe 8th dey of _ Mav ,19 73
~ SOOK~..1V P~bf~:7pV
~ 5?GNATUR TITLE
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' _ Chi:f, Soaci~l troced~re• Stiff
~ :N4TE •,ni~eo~~ o~ olhc~r o„iKwl~•d by low ~o ro4• ee~nNl~do~~~~~ s ne~ eas~n+.ol ro r~ „ol~d~~y oF NWic~ 01 F~A~rol Toa L~rr G.C~1. -
i ~6~1 ,~10~051. I~S.1 S,
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~ PAR13--To b~ us~d tor r~cordinp purposss
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