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Form 668
(Fiav. Sea~a~~~bar 187~,;
Oepartmer.t oi the Treasury - Internal Revenue Service
Gertifica#e of Refease of Federal Tax Lien
District I Serial Number s~~'~Q
a~.~v
__ ~~~r ~~519450 bk-350 pg-198
I certify that as to the following-named taxpayer, the requirements of seciion 6325(a}
of the Internr:t Revenue Code have been satisfied for the taxes listed below and
for all statutory additions. Therefore, the lien provided by ~Code section 6321 for
ihese taxes and additior.s has been released. The proper ofiicer in the office
where the notice of internal revenue tax lien was fited on March 6th ,
19_g.~, is authorized to note the books to show the release of this lien for
these taxes and additions.
•~_ ~[ T..
IVd111~ V~ ifiA~xi)t+i
Residence
Kind of i'ax
(aJ
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~ a.s. ~.o- st.
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Tax Poriod Enaed
(b)
~~
Date of Qssessment ':
~
(c) j
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I r
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Place of Fifing ~~ ~ ~ ~~t ~`
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lret P!al+et~ !L . 33~i~50
Unpaid Balance
of Assassment
ls1
~~~
Total ; ~ ~.~1
Th~s cerUfi~ate v:as prep~red and signed at ___ ~I~~QL1,Yi~le~ Florida_ _ _ __ __ _ _ __ _ ______ _ _ , on this.
the _ _ lgt~ day oF _~tar~19 __$1 ~
- - - - - --- -- --- - ------ - -- - - - ---- - -- ---- - -
Signat.~re iJ .`~~ ~ ; Title
~ ~ Chief, Special Pro~.edures Staff
~ '
~Van E. O'Neal' ~- __
(t~o:s: CerUl~cato o/ otbcttr authonraJ by law to taNe a~HnowleUyr:ienrs ~s not essenbal fo the ra7~d:ty of No1~co of
Feds: ~! Tax C~on G.C.M. ?W 19. /950./, C.B. 125.) ~:{~ {/W
~~~• ~~ Form 668 (Rev ~78)
Pan 3- To be used for recording purposes
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~le+Wt k tilq~ ~e!
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Fo/ Opfional Us9 by Recordrng Oflite
19~1 MAR ~~ P~. ?~ ~18
-': E C n f:q~ rc ci
S'. l.l'C~'~~lki iY.'F'i A.
r~G~R Patfi~1.5 ,~
~~rK~c ciF:u~~ cn~r ~
• _ ~ . ~,
5~1;358
Identifying Number
[d)
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