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Form 668 Depertrrient of ttNr7reasury -Internal Rrwnue Service 4~~~ "l
~Aer sept.tnoer 19,9, Certificate of Release of Federal Tax Lien
District Serial Number ~ For opHpra/ rlse by RaeordYip ollice
1990 FE8 26 A~; 41 }
- 40
f certify that as to the following-named taxpayer. the requirements of section 6325(a) STtlt
CtE
CCiNiT
Fti?.
of the tntemat Revenue Code have been satisfied for the taxes listed below and itOGER POITRAS
for all statutory additions. Therefore. the lien provided by Code section 6321 for CLERK CtRCU1T CQ3RT
these taxes and additions has been released. The proper officer in the office RfCeP,P 1~'ERlri£D__._..
where the notice of internal revenue tax lien was filed on June 29
~ 19Z2_. is authorized to note the books to show the release of this lien for 4,~1~
these taxes and additions.
Name of Taxpayer
QNSp C i R~ti Dist
Residence
tt 2 ~ ~ -
s.ti. ci , n ~lsoss
Unpaid Balance
Kind of Tax Tax Period Ended Date of Assessment Identifying Number of Assessmsrii
ray rep r~~ rd~ ray
j 10~ 12-31-7d i-11.7'! 2K-i0-i~7a u~~s
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Place of Filing
j i . Cleslt it tw Ci~t3t Cant Total =
!'t. !l~atoet~ a2.3S
This certificate was prepared and signed at Jacksonville, Florida , on this,
the 219t day of February 19 8U _ PAS
Bq0[
Signature Title
1
Van E. O'Neal 1 ~ hief, Special Yrocedurea Staff
(Note: Cartiriure of otlicer eurhori by ?aw to r e acrv~ow/e.fyments is not essentrat ro the wfwity or Norlcs of
Federal lax Lien O.C.N. 26~r9, 1541, C.B. 125.) Clt
Part 3 - To He used for recording purposes Form 668 (Rev. X78)