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Form 668 , oer~zrMErrt oF n+E nlEwsu[r-Ratew~t rtFVEruIE sQ1nCe Fo. Oprwnof Use M Recwdng 016ce
~eEU. iaii~ - C~TiKATE Of ~~f iEDBtAI TAX L~1
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DISTf~CT SERIAL NUAABER ~
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1 hereby certify thot as to the following-nomed ta~ayer the requiremenh of Sec}ion ~
6325(a), Internol Revenue Code, have been sotis6ed with respect to the toxes enu-
merated below
to
ether with all statuto
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thot the lien for such tazes and stofutory additions hos thereby been releosed. The T~
proper of~'icer in the oN'ice where ~notice of intemal revenue tax lien was filed on ttiCGhh ~'E t~:F~F 9
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Nave~her 29th , 19]_4_", is hereby authorized to rriake notofion -
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o~ his books to show the release of said lien, insofar as the lien relotes to the follow-
in9 taxes. ~~
NAME OF UXPAYER
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RESIDENCE -
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UNPAID BALANCE
KIND OF TAX TAX PERIOD ENDEO DATE OF ASSESSMENT IDENTIFYING t~UMBER OF ASSESSMENT
(a1 (~1 k) (d) (e)
10~0 1~3~?2 Oi~73~~'~'3 ~740177 2~t~?9
10~l0 l~~'13 0~~?14 ~Or~~021! ~A4.a1
PiACE OF FILING
$~. ~.~ ~
~ ~ ~ . TUTAL ; •~_~
WITNESS my hond af _Tackgom~ille_ Flerida ' , on this,
the 20th doy of Feb~ , 19_$1
La~ E~ 0' Neal v ~~''~ ~ ~\~ f rh~ ~f~~e..i,.~ px~o~..,,P 4 Sr,Bff
(NOTE: Cutificate of ofFicer auN~onzed by law to toke ackrawledgments is not essentid to the volidiy of Notice of Federd Tox lien G.C.M.
26I19, C.B. 1950-S1, 125.~ ~
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; PART 3-To be used for recording pur~ p~~
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