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F~ (~Q~ Ospartment of the Treaaury - Inten-ai Rwenue Sarvice . .
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,~,.,-~~,9~ Certificate of Release of Federal Tax Lien ~
Oistrict Serial Number ~~a Fo. ovuona~ uss ny Recoro~n oa~cs ~ ~
!~~_~ 4Z2659 BK-297 pg-801 ,~ ~~ 8 NI ilt 48 ~
I hereby certify that as to the following-named taxpayer the requirements of p~1
section 6325(a), Internal . Revenue Code~ have been satistied with respect to ihe S~~~UC~ C T• ~
taxes enumerated below, together with all statutory additions provided by section ~E~i C~CUIT
6321; and that the tien for such ;axes and statutory additions has thereby been
released. The proper officer in the office where notice of internal revenue tax lien RCCOR(! t'FRI~iED___ _~~ _
was filed on Novemher 3 , 19..~~, is hereby authorized to
make notation on the books to show the release of said lien, insofar as' the lien ~~~ . ~~
relates to the fotlowing taxes. ~ .
Name of Taxpayer ~
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Residence
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! Unpaid Balance ~
I Kind of Tax Tsx PKiod Ended Osts of Assessment Identif~-in~ Number of Assessmsnt
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` Place of Filing
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~ Wit~68S my hand at Jacksonville, Florida . on this,
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~ the 27th day of Februa 9 81
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~ Slgnature ! Tltle
~ Van E. O~Neal Chief S eci
(Notr CertiNcafe ol ollrce~ aufhorired Dy law 1o take acknowledgmenls ~s nof essenfial lo fhe ralid~ly ol Not~ce o! '
Fedeial Tax ~iep G.C.4I. ?6t19. C.B. 1950-1. 125.) "(~~ p~~~$
; P~ut 3- TO b9 us6d fOr ~eCOrdi~q purpo~ Form 668 (Rev. ~-78)
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