HomeMy WebLinkAbout0660 _ - Ci/
FOnn Department of the Treasury • Internal Revenue Service 4~1~
,R,,,. ~ef,,,,,K,s,a, Certificate of Release of Federal Tax Lien
District _ Serial Number For ovnonal v:. M Reeordtrq o1t(c.
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Jacksonville 41291? B-292 P-1? ~ f ~j
I certify that as to the following-named taxpayer. the requirements of section 6325(a) 3 • ~ A!•
of the Internal Revenue Code have been satisfied for the taxes listed below and Q
for all statutory additions. Therefore. the lien provided by Code section 6321 f ~ 7
YfR}f1,r___ _ _
these taxes and additions has been released. The proper officer in the office
where the notice of ii:temal revenue tax lien was filed on August 7th 4'~'~'i'7~
193$_. is authorized to note the books to show the release of this lien for
theSB taxe3 8nd additions. .
Name of Taxpayer
Karl H. Keller .
Keller's Texaco
Residence
~ 1826 Orange Avenue
Fort Pierce, FL 33450
Unpaid Balance
Kind of Tax Tax Period Ended Data of Assessment Identifying Number of Assessment
(a) lbl (c) (d)
941 03-31-78 06-19-?8 59-1299778 530.68
941 12-31-7T 05-22-78 " 994.22
941 09=30-77 I 05-22-78 1,189.30
I 941 03-31-77 10-10-77 " 1,011.27
I 941 03-31-76 08-22-?7 ?14.77
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~ ~ Place of Filing Clerk of CIrcuit Court
St. Lucie County Total = 4,440.24
~ Fort Pierce, FL 33450
This certificate was prepared and signed at Jacksonville, Florida on this,
the 22nd day of Ft;~uary 19 80 _
Signature Title a
60~~ tA6f VvC7
'Neal ~ Chief, S ecial Procedures STaff
Van E. 0 P
Mae: Cettiticafe o/ ofliter aurnoii:ed by law to take ecknowledyments !s not essential to the validity o1 Notice of
Federal Tax Lien (i.C.M. 2811. 19541, C.B. 125.)
kg Form 668 (Rev. 9.76)
Part 3 - Tn M rres~rt tcu recording ourDOSes