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i Form 668 oer~Rr~ENr oF 1?+E t~Ewa~n-NrEe+~t eEVEr~ul~ 5~1nce Fo. opriono? tb. ~r It.oo?d~g olFcs
ta~t. ~ a~ i) C~T~KATE OF REIEA3E OF FEDERAL TAX.tlEI~I ~
DISTpCT SERIAI NUMBER ' `f
Bk. ` 241 P. 752 ~ t' c« COURT ~
' 1 hereby cernfy Nwt as +o ihe follow~ng-oamad roxpoyer M~e requ~remenn of Section :,~cG~flf~ .
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. 6325(a ; Internol itevenue Code, have bee~ ~atisfie~ with respcct to the tdxes enu- .
: mera~` bebw, together with ai) stotutQry odt~itions: provided by Section 6321 • t~+d . I1rC 6 i 5 3 1"~~~
t F a t 1 h~ lie n f a s
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th t
a x
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s and statut
o
ry adddions; has tl~er
e b
y been releosed. .jhe ~~C
proper officer in the ofFice where notioe of`int~d revenue tax lien wos 61ed,'on
.j~.~v 1_, , 19~:, is herebr outhorized ~to diake netNion
on his books to show the releose of said lien, i~ofar os the lien relates to the fol(ow- -
ing taxes. _ -
NAME OF U?XPAYER
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RES1DEt~E ~
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tx~Pa~ enuwcE
KIND OF TAX TAX PERIOD ENDEO DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
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t~M I~7t 3~0~7~ ! Stt.~
~0 ~7~ aS•ll~7i ~~l~! - 1~l~A.li
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~ PiACE OF FIUNG ~ ~ ~
$j~ L~ ~T'Y TUTAL S
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~ 'vv~TNESS my hand at Jacksonville Florida , on th~s,
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~ the.~1&~doy of November, 19 77 '
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~ uGNAT T1TLE
i f s ecial Procedures Staff
(NOTE: CatiAcde of olFica outFwrized bp low to take ocknowledgmenls is no1 essentid to the volid"8~~~~ ~d TQ,x~ G.CJVL
~ 26<19, C.B. 1950-51, 125.) _ ~
PART 3-To be used for ~ecordiny purpos~s rs
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