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Department of file Treasury -Internal Rwefwe Service
~ 1=orm 66a
~Re,,.~e,,,~,9,a, Certificate of Release of Federal Tax lien
District Serial Number For optforw u:e by Recordirq office
1~~~11L 460610 b-317 p-1372
~9t9 NOY 19 P~ 3 4 0
i certify that as to the following-named taxpayer, the requirements of section 6325(a)
of the Internal Revenue Code have been satisfied for the taxes listed below and F'LEO AND RLGUnui ~
~ for all statutory additions. Therefore, the lien provided by Code section 6321 for S ROGER
POITRAS A
these taxes and additions has been released. The proper officer in the office CLERK CIRCUIT CWRT
where the notice of internal revenue tax lien was filed on tPZn*Pm}fPY 72.t'h P.ECGf:O VEP.,EiEO_
t9~_, is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer ~~aS14
Residence
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j Unpaid tialatttre
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
(a) lb) lc) (d) ls)
~ f 941 1~3~r7~ 03-14-79 99-~37•~ 3s160.bs
~ 03-~ ob..~ z,~s•n
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Place of Filin
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~ i ~ LfS~t ~ Total i 3~~•S9
on this,
This certificate was prepared and signed at Jacksonville Florida
life 9th ~ypf November ~Tg 79
Signature Title .
Van E. O'Neal Chief S ecial Procedures Staff
Malec CertHlcate of officer a Aorizad by ww take fuwadad0manta b not aasantiaf to tM vaffdify o1 Notbe o1
Fedara/ Tax Uen O.C.M. 2411!! 10541, C.B. 126.) a~ C~ rA~1C VW
Part 3 - Tn ha ..enA 1nr ra~rrrdine etlrDO~AS Form 668 (Rev. 8-78)