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HomeMy WebLinkAbout0582 - . ~~ Form 668 DePenment ot the Treasury - Internal Revenue Senice 1Rev. SeDtember i$7i3i~ ~e~#ific~#e o# Release of Federal Tax Lien = ~IStfICt Serial Number ~~1 ~~ fw Optional Use Oy Aecosdmy Oflics ~` AR 23 P~: 2 O7 J.ek~o.~.ill~ ts. - - -- F~~rr er;r F~ cof,~~ :~ 1 certify that as to the following-named taxpaye~, the requirements of section 6325(a) SL ~u~~f CoUV t r.l t.~. of the Internal Revenue CodE have been satistied for the taxes listed betow and ROGER POl7Rr.5 for all statutory additions. Therefore, ihe lien provided by C~de section 6321 for C~ERK CIRCUit c~u:~t/~ these taxes and additions has been released. The proper officer in the oNice '' ^~ " ~ ~ where the notice of internat revenue tax lien was filed on ne~emher 2~rd , 19~_, is authorized to n~te the books to show the ~elease of this lien for ~~~~5~~ these taxes and additions. i~aitie ui i ~Nay~i ~ ~Obss'! ~ lttiti~ D~!/~itl~ Residence 2215 11 ~3ta stsMt . Tt M~ses~ R. 33rS0 Unpaid Balance Kind of Tax Tax F'eriod Ended Date of Assessment ~ Identifying Number of Assessment (a) (bl ( (c1 N (d) - (e) --- ---------- -- -f- ----4-- - -- -- ~ ~ io~a-~o ~eiz j 11-o3-so ~ Zu-~~~ss i,s~o.so ' 10~0-30 T912 ~ ~i-02-~0 ~ " lT.4S I ; I ? ~ i I i ~ ~ ~ I ~ ~ ~ ~ _ Place of Filing ~~~ ~isroit Corrt ' St Lrtl~ Ca~w Cor=tlww~ ` « pi~tcs. n 33430 Tatal ; S 1~77i.2S Th~s cert,`:ica~e ~vas t~repared ar,d s+yned at Jacksom~ille, F_la.__ __ ______ _____________ __ __-_ __, on th+s, tne lE~th__ day of _~tarch___ 81 _______. - - -- - - --- - -- ,- - ---- ------ --- - - - - - -- -- - - Sicr,atuce ~ ~ Title ~ ~ ~ Chiefj Special Procedures Staff ' (Nute: Cer;~hca!e o/ ofLcor auMcrli^.~i b/ 'aw to fa~~i a~t~nowiedgments is not o• e~al to the va~~dify of Not+ce ol Federat Tai l~en G.C.M. 2G419. t954t, C.B l25 ) ~~~ ~~i 8:"i~k'; ~, ;'~ Wi clt Part 3- To be used for racording purposes Form 668 (Rev. a78)