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Fottn 668 Deputment o/ the Treasury -Internal Revenue Service
(Rw.Bepterrlber,9T8, Certificate of Release of Federal Tax Lien
District Serial Number ~~qr For Optlona/ Uas M Racordap OtNC.
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I certiy that as to the fallowing-named taxpayer. the requirements of section 8325(a) ~ ~C eKC ~'CC~oFo
of the Internal Revenue Code have been satisfied for the taxes listed below and S F~r~:,~
~ !'.)itit~~
for all statutory additions. Therefore. the lien provided by Code section 6321 for Cii=.ri t«:~u+i Cci,'
these taxes and additions has been released. The Rroper officer in the office R.csxt~ ~•f -iF ao_
where the notice of internal revenue tax lien was filed on_~,~~
f! 19~, is authorized to note the books to show the release of this lien for
these taxes and additions. SQ5835
Name of Taxpayer
t.C. i C~13a~ 2si~dtait
Residence
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Kind of Tax Tax Period Endaif Date of Assessment Identifying Number of~Assossment
tau toy t~~ tai c.~
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1010 12/)1/3'2 02/23/7 S+rl•SO-7131 •.241.65
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~ Place of Filing
~ Cl~rlt. tYtt.+s~Et Comet - i
st. LrsLf: CMnt~ Total i ~a241.iS
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This certificate was prepared and signed at , on this.
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theme day of ,19
Signature Titte
tf/otac CavtHtuts of olJfcsr autAorizad try law to take acknoarladym.nts k not aasantlU fo tM vaUW7r of Notic. 01
Fidaral Tai Uan O.C.M. ?AI1D, 1D5O1, C.B. t25.) a (,j~ s~
e Part 4 - r Yslel~liA~1 r Form 668 (Rev. 9-78)
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