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'form 668 oEtiur~r oF inE n~Ewsut+r-N~Ea~,~u eEVEr,a~ sNmcE f•o. op~~w~o/ v~. ay Reoadk~g
~aEV. ~ a~ ~ y C~FiGTE Of REIEASE Of ffDBtAI TAX ~N
' a~~ .1A~K9QNVlI.t.~ SERIAL NUMBER 7 ~ E 6~p A~~ ~r4~E~
~ 8-239 P-1160 S~. o~E~ P~fTpAS Cx
i F?ereby certify that as to the folbwing-narr~l taxpoyer~the requiremenh of Sedion -•`^K ~•'~CUtT ~CL
6325~a), internol Reve~ue Code, have been satisfied with respect to the taxes anw '~~F~
meroted below, together with all stctutory addiiions provided by Secfion 6321; and f
that the lien for such toxes and statutory c~d'~tions hos ihereby bcen releosed. The J~l 26 12 vs PN 1~ -
~~MaY~ "L ;n the o(fice where no 9~f irNernol revenue tax liee wos filed on 4~.~1.~2
, , ts hereby authorized to rtfake notation
on his baoks to show the rdeose of soid lien, insofor ~ the lien reiotes to the follow-
in8 foxes.
NAME OF TAXPAYER .
S~~ li l~aki .
RESIDENCE ~
~~lM .
UNPAID BALANCE
KIND OF TAX TAX PERI00 ENDEd DATE OF ASSESSMENT iQENTIFYING NtJNIBER OF ASSESSAAENT
~ (°l ' (bl Id1 (gl
~ t0i0 1=~31•N 0~~0~-1~ til•~ttl~ l,i.N7.~
~ 32-Jt-~ O~•53•~1 li~u•41'!0 ~S.lt=.S!
.
,
PLACE OF FlLING ~ ~
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~T P~„ F~QA TOTAL S 53~~•~
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WITNESS my hand ar Jacksonville, Florida , on ~h~s,
y1e 28th ~r o; June , 19 78
SIGNATURE TiTLE
Frank L, johns Acting Chief, Special Procedures Staff
(NOTE: CMifica~e of offrcer ovtFwrized by low to toke ack~nowledgmenls is not essent;ol to the volidify of Notice of Federd Tox Lien G.C.M.
26419, C.B. 1950-S1, 125.)
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