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~ _ OErARfMENT OF i1E TlEASURY-NiERNAI REVENUE S~vICE For Optiono! W~ dY Rsawd~^8 OIFt~
~ Form 668
~~v iao~ CERTWCATE OF R~EASE 0~ ffDRAI TAX l~l /
- o~s*~ncr sERw~ Nur~~a ~iv°c+~ co"~~1~
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f hereby cefify tfiat os ro the fdbwing-nomed roxpayer the reqvirements of Sectioo RECORO Y~F~FIFO
6325(a). Interreal itevenue Code, have beer~ sotisfied wi?h resPact to the toxes eow
, merated below, rogethet with all statutory add~tions provided bp Sectic+~? 6321; and ~ 9 12 i~ P
that ~he lie~ for such texes and sfatvtory oddi6ons has thereby been released. The ~jd
prope~ ofE'icer in the ofFice where notica of inlernol revenue tex lien was filed on . 7
ltoveober 11 , 19~1. is herebp authorized to niake nototion . -
on his books to show the release of sv~d lien, iruofar as the lie~ relates to the follow- -
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NAME OF TAXPAYER
~M~ ~ Lwd~r Ca~el+~a -
RESiDENCE
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UNPAID BALANCE
' KIND OF UX TAX PERIOD ENDEO ASSESSMENT DATE IDENTIFYING NUNI6ER OF ASSESSMENT
~a~ ro~ c~i ~d~ t`~
I~ ' Lo1,p ~-3ti-'~'~_ ~-Ti ~it.~oai~O ~l.i~
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~cE oF Fiur~c
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~~S TOTAL 3 ~ T
h~ Marro~s ~el~i~ -
':YITNESS mr hond at Jackso*wi 17 e_ Flori e , on this,
;rP 3rd doy of Sevtesber, 19Z4
SIGNATUit ~ T1TLE -
Chief S ecial Procedures Staff
( E: C ~fitote of ofPicer outhorited br ~a+M ~o take ockr.owledgmmh is nd essen!iol to the val~drty of Notice of Fecier~l Tox t~en G.CJVI.
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PART 3-To be used for recording purposes B~OK YAGE
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