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FOflll ~ Dt~p~ttlnfant Of tiff Ttwwy-,~ntottlM AfaYNNN SOfYIo~ -
.r,~>a, Cerfiflcate of Release of~'Federal Tax Lien
SsNal Number For Optional 1/ao oy Raooratlr~ p/roo
~ 437282 $x-3os rc-22s ~ 9 A~ '8 AM 11: 35 ~
I oertHy thait as to the following-named taxpayer. the. requirements of section 8325(a) ~ ~
of the irrternai Revenue Code have been satisfied for the taxes listed below and .
for ell statutory additions. Therefore. the lien provided by Code section 8321 for
these taxes and additions has been released. The proper in t~ office RECtlRO VER~tEb
whew the notice of internal revenue tax lien was hied on march 15-
19 T~9y . is authorized to note the books to show the reieasa of this lien for ,~~~,g~ s
these taxes and additions: ~
Name of Taxpayer
t~~~
Residence
!Od !fir fir.
Unpaid B~alsnce
Kind of Tax Tax Period (Ended Date of Assessment IdentHyirq Number of Assessment
(U (6) (W ld)
p
~ t
9f1 1~fF7t 1?~1'i' ~7~ ~ 9~.7:~
Place of Filing _
j,~p~ 'l ~ Total = ~si.~
lt.. !fie !1. ~3~Id0
This certificate was prepared and signed at JACxsntava .F, .ne na . on this.
the 2 7 day of Jul 79
t
Signature Title
VAN B O'NBAL~~~~ CHIEF SPECIAL PROCEDURES STAFF
. ~ p'10b: CanHicala of oHicp authorizstl Hy law to fake achnowletlpmanb h not aasa~rttlN ro tM va?kilflr o1 Natiw o1
r Fodaral Tar Ll1n O.C.Ai. 26t1D iab0.1, C.B. 1?b.) ~
~ Part 3 - To be used for recording Form 888 (Rev. X78)