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Form 66S OfPARTMENT OF TME T26W1Rif-WlERNK REVENUE SERVICE For Optioral Ufe BY Recordng OAice
~REV. ~a~~) CERT~ICATE Of RELEASE OP FEDBtAI TAX UEN - ~{~{~Q
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DISTRICT . SERIAL NUMBER RObf R POIT~
~~1],~ 284105 B228 P1248 CIERk CiP.CU1T ~ RT
RECORD YERIFIE@ ~
1 hereby certify that as to the fol~ow~ng-named taxpoye~ the requiremenh of Section
6325(a). Internol Revenue Code, have been satisfied with respett to the toxes enu- ~ j~ ~~7~
' me~ated below, togethe~ wi~h all statutory odd~tions provided by Section 6321; a~d ~
thot the lien ~ for such taxes and stotutor~ add~tions has thereby been released. The
o pfFicer ' the off'ice where ~oh~ f inte~na) revenue tax lien was filed on
une ~0 , 1 q , is hereby authorized to nialce notation
on hi books to show the releose of said lien, irlsofor os the lien ielates to the foliow- ~ppp ,
ing tmies •s~Q
NAME OF TAXPAYER
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RESIDEN~,E ~ I~
Zsai
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UNPAID BALANCE
' KIND OF TAX TAX PERiOD ENDED DATE OF ASSESSMENT IDENTIfYING NUMBER OF ASSESSMENT
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~ ' PLACE OF FtUNG -
TU7AL s
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~ WITNESS my hond at Jacksonville, Florida , on th~s,
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~ the 17 th ~Y of J une ~ 9 74 ~
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SIGNATURE / TITLE
l~ ~'Z . { - f~C t`~-c
Jack t Chief, Special Procedures Staff
~A (N ificate of officer outhorized by low to toke ocknowledgmenh is not essential to 1he volidity of Notice of Fedad Tax lien G.C.M.
~ 264 , C.B. 1950-51, 125.) kb
PART 3-To be used for recording purposes b~~
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