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Fonn 668 oEr~~rrr oF n+e n~w~rr~a~u~ ~vQ+ue s~e~ 1br opnww~ w. sr lt.oo.d~r~ o~rc.
(R~V. 1-ZO) • C~TWCATE OF RELEASE OF FEDRAL TAX l~I 0 ~
p~~~ SERIAL NUMBER ~~A POn~
T3i. 220700 8198 P317 Rx CtRCUtt ~
'I hereby c~riify that as to the following-namsd taxpayer the requirements of Section o vEr~tif~EO••••r"~•
6325(0), Interno) Revenue Code, have been safisfied with respect to the toxes enu- ~q ~
metated below, togeihe~ with all statutory additions provided by Section 6321; and j~ {6
Nwt the lien for such taxes and statutory additions. hos thereby been releosed. The ~nQo
e r~n
proper ofFice: in the ofi'ice wh~e noticeQ mtemo) re~renue tax lien was filed on VO
DeCealber 17 , 19 7, is hereby authorized to make notation
on his books to show the release of said lien, inwfar as the lien relates to the follow- _
ing toxes.
NAME OF TAXPAYER
J~Ct ~c ~ !j/i~.
, , -
f~51DENCE ~ ~N. `
r.~t li~w?, !1~••3~k9~
' UNPAID BALANCE
! KIND OF TAX TAX PERlOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
la) ro1 k1 (d1 ~e~
1~ 1~j1~-~ ~3-~ ~Qr7-Z2-C~ ,
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E 3piyp ~-~6T l~,il~-60 i6T~
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~ PLACE OF FILING Cl~' -~i,~
: S~r. L~ TOTAL ; ~.06
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~ WITNESS my hand or Jackaonville, Florida , on th~s,
a:1
~ 3rd ~y o~Dec~nber ~ ~ q 73
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TITLE
SIGNAT /
~ !L!'~1~~ ~t Z !c ~<~l/
Jac aat ~ Chief, Special Procedures Staff
~ : CertiRcate of ofEcer ovthorized by law to take 1 a not 1 the volidity of No6ce of Federol Tax Lien G.C.M.
X~ 26419. C.B. 1950-51, 125.)
PART 3-To b~ vs~d for rocordinp purposes xcc
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