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i Form. V~IV ~ Dsprartn?~nt of fM Traarury - Inbrl+al Rrvenw 8dnrics ~~~~I 5
i (Rev.B.oranb.r,~Ta, Certificate of Release of~ Federal Tax lien
District S~iial Number For orrlaw uaa ~ n.oordwro
J~~tfii 482583 Bk 329 Pg S23 ~ A(~ •s ~
' I certiy that as to the following-named taxpayer, the requirements of section 8325(a)
of the internal Revenue Code have been satisfied for the taxes listed below and ~
for all statutory additions. Therefore the lien provided by Code section 6321 for C
these taxes and additions has been released. The properApff~r l~ the office RECCitO v~RIF1E
wher~he notice of internal revenue tax lien was filed on
19 . is authorized to note the books to show the release of this lien for A9`~C
these taxes and additions. '3 a~
Name of Taxpayer
~ ~li~lr~e a iitil`etita Sande
i Residence
~s ltala~i a1.,
~ rt, !1.
Unpaid Balance
! Kind of Tax Tax Period Ended Date of Assessment identiyin~ Number of Assessment
la) lb) [W [d) [oJ
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Place of Filing _
C3atlt d C,Lloorti! Cwlle!
s!. tea? Qasfa? ti~0aR818Mte Total ; a.iK~'tx
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I~ This certificate was prepared and signed at Jacksonville , Plorida . on this.
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the ~Sth~y~ Jul ,1g 80 `
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~ Signature j Title
E Yan ' ea Ch~tif, Special Procedures Staff
(Natae Carffiura o? oniesr aurhwt:ed by law ro rake aeknowladpmanrs is not aasanru/ to tho valldlty otcJ6oUZ~2~fi/80
Fadpal Tu Lhn O.C.M. 26x/0, 150-1, C.B. i25.)
' Part 3 - To be used for recording purposes Form 668 (Rev. ~Te)
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