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~ F~ QQQ J D~partment ol tM Trsasury - Int~tnN R~v~nw S~vfc~
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j (Rw Septwnb~r1~78~ Certificate of Release of Federal Tax Lien
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DisMct ~ Serial Number S~_ ~.894 ~ F« °°"°~.' ~'. °y R.~°-~,° °~,`.
~ J ~• 491281 Bk 334 PA 2 ~30 OEC 30 PM ~t ~+ ~
~ 1 ce~tity that as to the fdlowing-named taxpayer. the requirements of section 6325(a) f0.E0 ~ FE TY~ .FIA.
' S(.IUC G
i of the Intemal Revenue Code have been satisfied for the texes listed below and ROG£it P ITRAS
for ail statutory additions. Therefore. the lien provided by Code section 6321 for t~ERK CIRC~T COVRT D-
these taxes and additions has been released. The proper offioer in the office R} (!(:Fi;• 1'rFIF'( ~_ _~T
where the notice of I~temal revenue tex lien was filed on June 30 ,
19~_. is authorized to note the books to show the release of this lien for
these taxes and additions. :~~ ~.894
Name of Taxpayer , '
sa~~ t a w,~r ^ ~
Residence ' • ~et 4m!
~t !l+~s+0~~ !L )34s2
Unpaid 8alsnce
Kind of Tsx Tan PeNod Ended Dsts of Assesament IdenWyin~ Number of As~essn~nt
ta) tD) lc) taJ f•l -•
~ 1~~~ ~Z 0~1~~ =~~+~7~ ~~WZ~~`
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' Place of Filing
~ C~~lll~t CNr~
~ ~, Rt~~~~ Total i ~l,btl.ii
This certificate was prepared and signed at _iacksonvt 11 P~ Flnriria , On thlS,
the 22th dayof .19 8P
Signature l Title
~ ~. . .
Van E. O~Neal rhipf~ S~tsri~l P~Drdlnrnn Ct.+CC
(Not~: Catific~t~ ol oNicN ~urnwlt~d by law to ako ~eknowl~dpm~ufs Is n wJ to tM vaJldiry o/ Notle~ ~~m
F~Wn! T~i Li~n O.C.M. 2611~, /~54t, C.B. 12bJ ~ r
w e~ c~,'1'~ PAGE ~151
Part 3- To be used tor recordtnp purposes, Form 668 (Rev. 9-78)
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