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Form 668 ~P~T~~ ~~~~~"~~~N- ~'~Nl1E SERVlCE For Opranol Uie By Recwdr,g OfF.ce
~rt~v ~-~o~ • CERT~I~TE Of RELEASE OF I~DERAI T~X UEN . f~a
s1_t~:y/f ~,liN~1f Ft.~ -
uISTRICT SERIAI NuM
BER QQGEN ~~~T~ ~
Jaaba~ll~ 236202 - B-205 P-171~2 C~f~,. ~~~~T cou~
P.fCQr.^ YE«'clf~~-- + :
I he~eby ceftify thot as to the fo!lowing-nam~d taxpayer the reqvirements of Section ~
6325(a), Internol Revenue Code, hove been sofisfied with resped to ihe taxes enu- ~S p~ ~T1~•'~
merated below, together wiih all statutory odditions provided by Section 6321; and ~0 Z~
that ifie lien for such taxes and stotutory oddit+ons has thereby been releosed. The ~
pro~e~ o~er2i~pt~ie ofi'ice wfiere nolic~Qf inFernol revenue tax lien was filed on
8u , 19 is hereby outhorized to rtioke nototion
~ on his books tp show the release of said lien, insofar as the lien relotes to the follow-
ing toxa.
NAME OF TAXPAYER
L~oo~rd J. i Yaod~ s~l~n
~s~~t~cE ~t. Pi.a~e.. ~i ~~4y0
; UN~AID BALANCE
I K1ND OF UX TAX rER10D ENDED ASSESSMENT DATE IDENTIFYING NUMBHt OF ASSESSMENT
~ la) tb) k1 (d) I~f
F
S ~?2 3~3-~-9?SSS ~ 99
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x~ PUCE OF HUNG
:3 (:et ic. verau~t CGWt TOTAL s ~
St. luc~e Ca:~nty
~ F~~t i~s~e. Flcrtcfa
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,4; Jacksonville, Florida
WITNESS my hand ot , on ihis,
s'=;
rhe 22nd ~ o fFebruary 19 7~+
Y •
~ S~GNATURE TITIE -
~jS
Jack Durant Chief, Special Procedures Staff
~ jNOTE: Cerh~ic of ffic r ~.or:zed by law to }ai~e ~CknOwlE~jmE'il!S is not e;s~rt~n? to thc val,d~ty of Nufic~~f~` Tox l+en ~
- 26419, C8. 50-5i 1?S.) QC~~ /,~?fr~ ~A~E
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?ART 3-To be used for recording purposes
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