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F~ ~~~ ' ~ Department of ths Treasury - IM~mal R~v~nw 8~vics ~/~
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(Rev. SeptembK 1978) Certificate af Release of Federal Tax Lien
I District Serial Number ~~ ~ Fw ow~raw us. or A.co.arw onic.
i J 487066 Bk 331 Pg 1~~ 4S
, _ 1981 JAN 27 ~N ~
I c;e~tiy tttat as to the following-named taxpayer, the requirements of section 6325(a) sT itIC~E i F~c~~- ~.
of the intemai Reve~ue Code have been satisfied for the taxes listed below and p~~ t
i for all st~utory additions. Therefore, the lien pravided by Code section 8321 tor ~ ROGER POITRAS
; these taxes and additions has been released. The proper of~gr in the office ~~~ ~~~~ ~~T
I wheifl the noiice of intemal revenue tax lien was'filed on ~Y i~ ,~ft0~n t~~ ~rk z --
; 19 1fU ,~g authorized to note the books to show the relea9e of this lien for _ SI, ~a
~ these taxes and additio~s.
Name of Taxpayer
lMatoe Cit.s~or Ba~t3~as, 2sa., a~as~matiw . .
Residence
~ ~ ~~`'i;,~o ~
~ Unpaid 8atanos :
Kind of Tax Tax Period Ended Date ot Ass~sme~t Identif~tkp Number _ of Ass~nsnt
~ fa) (b) . fc) (d1 (~)
I
i. 9~-9 ia~-3t-79 ~t7-eo 99~,t7r63~ 95.17~.93
; Place of Filing
Cl,at ot C3~ea~d! Coost
i ~~ 1+rod~ Ce~r!' t~os~lioir~
; ~'!. Pi~, ~'1. ~~
This certificate was prepared and signed at Jackaomiille, Florid~
t~ 16th ~~ Jsnuary~~981
Totsl i ~5.173~99
. on tttis.
Signature / ~ Titie t
Van 8. 0'lieal ~ ^ ~Chief, Special Yrocedurea Staff
Mabc c.nmcar• a onre.. aurnor~s.a 0~- qw eo wcs .cknowNd~pnNna a nor .s..nrw ro a» ra1+W1~- a Narc. a~-
F«N-al T~t l.IMt O.C.M. 2M10. fYb41, G6. 12a.) 8~~~ ~~~A "
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' Pa~t 3- To be used for recordup purposes Form 668 (Rev. a78)
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