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Fom~ 668 oenu~r~r~r oF te±~ n~Ewwin-rrrEer~u eEV~+tIE sR+nce Fo. Opr~onol U,e ey Reco.d+ng Ol6ce
~REV. ~a>>; C~TNCATE OE REtEASE.,Oi FE08tAl TAX't~M p
DISTRICT ~ L~ AN
~lU~BR ~~.LaCIEIt ?9~~ilA~I.A
' '~~~"~'~'E ~3:L DicE237 Pg 2978 ' Q~~~K E 1';~~IT COURT
~ 1 hereb cerfi fhat as to the followi ~FG+?R'~ •Ift}I!lEO.........~
f y ~ ng-nartled roxpoyer the requirestersts af 5~.'~tiian
6325(a}, Internol Revenue Code, have beert .sq6sfied with ~espect to ihe toxes ~u- Yt
merated bebw, together with a!I statutory oddtiont provided by Section 6321; ond ~4 ~~1 ~
thot lhe lien for such taxes and stotutory additions has thereby been released. The ~
proper oMxer in the office where ~otite of internol revenue tox lien wos filed on ~
March_ 31 , 19'~5.-, is herebr outhorized ro~ake nototion ~~~2
on his books to show the releose of wid lien, insofar os the lien relates to the follow- -
ing taxes.
"A"?~.~i~~ ~ur~ Q. e~L~t
~~~~0 ~ ~ ~~il i~. llorl~ Poe~t
Lu~,i~~ IL 3~0
UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
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' PIACE OF FILING ~ ~
' ~T• l~~ ~N TOTAI S
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~ WITNESS my hand at *~~ksanvills, plasida , on this,
1
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~ the 15th day of_~~_, 19_ _7S
x
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~ StGNATURE T1TLE
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~ . J ~rant Chief, Special Procedures Staff
~ (NOTE: Cert of~ outlwrized by law to toke «knowledgments is not essentid to the volidity of Notice of Federal Tmc lien G.C.M
'~F 26119. C.B. 1950-51, 125.) ~ ~
~ PART 3-To ba ~sed for recording purpol~"' hds
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