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~ F~ 668
(Rev. September 1978) •
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Dspa~tina~t ol the Trepury - t~t~mal Rwenu~ SKVks
Certificate of Release of Federal Tax lien
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; District ~ Serlal Number ~~CC /~ ~ ~W~~ Us~ by R~oordlnp ONIC~
a~o~s ~~
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Jaelt~-llj+s~ ~i. 482579 Bk 329 Pg 519 _~
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~ I ceAity that as to the f011owing-named taxpayer~ the requirements oi section 6325(a) t Y.1
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ST i
nOGER POITRAS
~ of the Intemal Revenue C.ocle have been satisfied tor the taxes listed below end
~ CIERK CIiiCJIT CC 'i~
~ tor all statutory additions. Therefore, the lien provided by Code section 8321 for
these taxes and additions has been re{eased. The proper officer in the office ~~`'' `' '~` ~- ""-- -
~ wher~ the notice of internal revenue tax lien was filed on ADril iQ ~ 15641
19~Q_. is authorized to note the books to show the ~elease of this lien for 5
'. these taxes and additions.
Name of TaxpaYer ~ - ra l+~s*osttl~t~
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! Ec si~. odql.. s~i ..at Le
, Residence ~30 A~Lt N~i
rt ~s.s~, n ~.ss
Unpaid Bsisnce
Ktnd of Tax Tsx Period Ended Date ot As~essmsnt identityin~ Number of Assessment
(aJ (b) (c) (d) !~)
s~i-oi ~aiz oi-o~-so s~-os»s~2 s.a~.vo
~.oi ~o~ oi-o~-ro " s.sos.ss
; ~i-oi »a oi-o~-so " ~,~t.as
~i-oi ~90+ os-o~-ao - ~
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' F'lace of Filing
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st i,.~.s,. cors+~ Tae~ s u,aao.3~
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This certificate was prepared and signed at Jacksonville, Plorida
. or~ this,
~ 28th ~y ~ Jan .19 8Z ~
Signature i Tme
Van E. O'Ne~ ~~ Chief. Special Procedure• Staff
Moe~ c.rur~car• a onk« .urnwrz~d ey aw ro ar. acru+ow~.op~n«W, ~. Qc~ ~~rtai ro~~y~`~ a Nak• a hj~
FWNN T~r LJ~n O.C.M. 2d11Y. f~54t. C.9. 1?6.) ~1~~] ~7 1
, B00!( V4 ( PAGE .
; Part 3- To be used tor ~ecordln~ purposas Form d88 (Rev. 9-7e)
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