HomeMy WebLinkAbout0409 1 . _ ' _ .
Fonn 668 oe?~r~1f oF ~?+e new~xr-a+~a~uu rE:e+uE s~ev~ ror op~oed ua er t.oo.d~p o~a
l~ ~-~01 T~~ F LE~ AliO RECOR~EO
; DISTRICT SERIAL NUMBER • . S~. aQGEA
FO TRIr1S LA. ' W
~I viremenh of Secfan CCERK Ct~CU1T COURT ~p+~~
~ herd,y cert~fy ihet as ro the fdbw~ngaw taxpayu roq RECOR(1 Vtii'= IED~.~..~~
; 6325(a), intema) Rav~eous Code, have bsen safisf'ied nnih respect to the texes enu'
; „~a~ fioge~F~' with all statutory addifi«a provided by Section 6321j a~d ~ I I ii PM'73
+t,a~ ~ i~, fa a~,a ~aa~ ~ ~ ~~~a. n,~ ~5~454
ProPe~ ofl'iosr in ths ofFice where notioe of iobrnol ~~evenue tmc lien was filed on
, 19~~.,.; a herebY avthorized ro dioke ootation
' on his books ro show t e release of said i'ien, insafor as the I'~en rolaros i~o ths fdlow~
in~ tmcas.
NAME OF UXPAY6t
a ~
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aw.. a~s ~M
!~t l~rr. lf~rsW 31~
, UNPAID B~ALANCE
i KIND OF UX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMB6t OF ASSESSMENT
~ ca~ roi cd~ t~~
~ ' ~o~e ~.o.~. ~s.~.r~ os,~.~x ~ o~ ~s ~ e~x~~
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~ PLACE OF FIUNG .
~ C~~s C~R ~ TOTAL S 1~jM.~
- ii. Ll~i~ Qw~
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WITNESS my hand at , on this,
•
[:yj
the _~_day of_ 1
~
SlGNATURE . - TITLE
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(NOTE: Certif,cote of officer outhorized by tow to take acknowledgments is not essentia to fhe validily o Notice o d Tax Lien G.C.M.
~ 264i9, C.B. 1950- 51, 125.) ~
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~A~r
~='s ' PART 4-To be retainad by SPS SC~r
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