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Form 668 oEPllittMEPtr oF niE tifwSURY-r~ftERWU eFVEMUE SEtv~CE Fo. Opriona! U~e dr Recwdng ORice
~r~v t-~c~ CERTIRUTE OF RELEA~ Of fEDBtAI TAX UEN
D~STRICT SERIAL NUMBER
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I hareby certify that os to the following-named taxpoyer the requirements of Section
6325(a), Internal Revenus Code, have been satisfied with respect to the toxes enu- ~
merat e d b e low, toge t her wi t h a l l statutory o d ditioos provi d e d by S e ction 6 3 2 1; a n d
that the lien for such toxes and statutory odditions has thereby been released. The
prope~ off'icer in the office wnere notice of internol revenue tax lien was 61ed on '
Ju1y 30 , 19~_, is hereby authorized to moke notation
on his books to show the releose of soid lien, insofar as the lien relates to the follow- FILEO AN~ ~ECOROEO
' ing taxes.
ST. LUCI"c COIiNtY FLA.
NAME OF TAXPAYER ROGcR PO~TRAS
~~7N~7~7I~ CIERK CIRCI;I~ COU~~
RECOR!? ~'f?iF1E~ ~
RESIDENCE ~ ZO g 34 AN ~~d
j AO~e 3, Ho~t ~618
; P ~"taci~ ~
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
(o) (bl k1 (dl le1
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I040 Jt~come 12~3~•?T2 06•11~?3 4~ 24 4700 S 6I6.b0
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~ PLACE OF FIIING
; ~t ~t TOTAI S 61~i.60
= S~. Lu~it Ca~~tY
~ WITNESS my hond a~ .7acksonville, Florida , on this,
the 13 thday of Ma rch , 19 75
= 80~1Y ~
SIGNATURE % TLE
.
- Jac Durant C ief S
~NOTE: Certificate of officer au or~ d by law to take ocknowledgme~ts is not essentiol to the volidity of Notice of Federol Tax Lien G.C.M.
26119, C.B. 1950-51, 125.)
' PART 3-To be used for recordinp purpos~s
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