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' ~orm 668' U S?REASURY DEPARTMENT INTERNl~L 4EVE~CE SERV+CF ( Fc• 0;• U3e e~ Rr.rd ~~O~f c•
i iREV. &-671 tER11NCATE QF RELEASE OF- ifDERAI TAX IIEN f+lEt ~NG RE~o
! ~ R iA L NO. iT. LUCIE COt! TY
DISTRICT ~{4~CR POfTRAH
; J, 251987 B212 P2912 p(,[~1K CtRvUil COU~1t
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i 1 hereLy te~tify thot os to the iafiuwing-n~med toxpoyer the reqwrements of Section
63~5(a), Interno) Reye~ue Cade, hove been sotisiied w~*ti resrac~ to ~he taxes enu- ~T t~ ~Z Z3 P~'I
i merated bel; togethe• w~th ol[ stotutory additions provided by Sect~on 6321; ond
thot the lien for s•~th ta:es ond st~tutory odditians hos thereby deen relecsed. T{~e
properAp~ii i~~he oifite .~here notic~~f interno) revenue tox lien was F~led on
; - , 19 .~s hereby outho~~zed to moke notot~on
on his books to sho.v the reieose of soid lien, insofar os the lien relates to the
~ fo~~aW,~9 ,ox~s. 26"71'72
NAME OF 7AXPAYER -
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RESIDENCE ~ B~ • I
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i~. pia~e~ F1.a~iE~B 33~50
! UNPAID BALANCE
CIASS OF TAX
' (Tox Retur~ Form No.} PER10D ENDED ASSESSMENT DATE IOENTIFYING NUMBER OF ASSESSMEN7
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. PLACE OF r'1LING Q~j ~t
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~ WITNESS my hand or Jacksonville, Florida _ , o~ th~s,
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~ 23rd October 73 _ _ ~ _
~ tne day of ,19_
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SIGNATURE / . TI?LE ~
-C tiCi ~ 'yt[- Z ~--s-i a
Jack nt Chief, Special Procedures Staff
MOT .~*~f~~a~e o4 olFicer au+Fwi:ed 'cy !c.: t~ t:ie ock-,o«ledyre~~s ~s ~ot !sse~f~ol fo +he ~ol~drry of NoT~ce of ~ed_rol To¦ L~en G.Cld.
2641 , C.B. 195051, 125.1 .
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PART 3-To be used for recording purposes
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