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Fo~m 668 ' U S TREASURY DEPARTMENT - ~d!ER•:-~ RE•+Er~uE SE~~'~CE fo~ C~,~.4-.:t Jse Br RecwJ.~y ce
~ev. a-~: CERTifICATE OF REIEASE Of F~DERAI TAX LIEN ~ 1 LES
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DISTRICT SERIAL NO. ROG~~ POITR~~
J 193662 B184 P2127 C~ERK c+~CU:i CoURT •
1 he~eb. certify thot os to the (ollowing•named toxpoyer the reQuicements of Sec~~on ~~~ORC~ Yr~IFIEO
6325(0), internai Revenue Code, hove baen satisfied w~tti respect to the toxes ~T Il 23 FH'~~ ,
meroted belc+~, rogethe+ with all stotuto~y odditions prov~ded by Section 63?1; and
thot the lie•~ fo~ suc{, toxes ond statutwy addi?ians hos fhcreby been relecsed- Tk~e
propsr ol(,~;,pr in the ofFice where notic7~f ~nter~o) revenue tox lien was filed o~
1Ka~? LV ~ ~q ,;s F~ereby outhorized to moke netot~on
on his books ~o show the ~elecse o( soid lien, insofor os the lien relates to the
following taxes.
NAME OFTAXPAYER
D• Lktyd ~t liat'r JO~nfoA
RESIOENCE
~tt 1 Haz l37
j TorO lSu~o~, ll+orl+d~
~ UNPAID BALANCE
CLASS OF TAX
~ lTax Return Form No.) PERIOD ENDED ASSESSMENT DATE IDi i IFYING NUMBER OF ASS _SSMENT
(o) (b) (c1 (d)
~ LOi~D 12-33~68 5-9-69 =385.1~2
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PLACE OF FILING . Cl~~~ Qi~Q~t ~1'~r
sL~ ~i0~ TOTAL 5 3S~j~4Z
Tbr'6 P1~!"O~~ ~]~q~1~ds
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:.xk
Jacksonville, Florida
~ WlTNESS my hand ot on this,
u.`ji5
xY, a
23rd October 73
the __doy of ,19 -
. ~ 0 ~ 'l89 -
F~::
~~h~ TITLE
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°4" SIGNATtJR - "
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L,{'r.y~_.' ~ - ~C L « -t._- V /
J8 ~nt Chief, Special Procedures Staff
_erfiiicore o~ oFfice. ourhx~:ed by la+v ro take ac4nowleEymer.t~s ~s -ot essen~.o' r~ t~e ~ol~d~ty o~ Not~ce of Federal To¦ L~~r G.C_M.
26119, C.B 195o-51. 125.)
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PART ~To be used for recording purposes
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