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Form 668
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" pepartmert M the Trsasury - Intemd Rwenw 8ervice ~
_ Cer.tificate of Release of Federal Tax Lien ~
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District Serial Number si~O Fo- OpNOnal Ut~ bp R~co~dlnp OlNc~
J~~O~Iyii 482588 ORBK 329 Pg 528 ~~EB 13 AM I~ 04
FILlO RNC FfcOPOEO
i c~e~tiry that as to the fdlowing-named taxpayer. the requirements of section 6325(a) st. ~1tClf C01NiTY. FIA.
of the Intemal Revenue Code have been satisfied for the taxes listed below and RoGER POItRA3
for all statutory additions. Therefore. the lien provided by Code section 6321 for ttERK CIRCUtT CGU 1~
these taxes and additions has been released. The proper offioer in the office ~~!'~~`' t' F'` "~ _-.~ ----
where the notice of intemal revenue tax lie~ was filed on gp 51~
19 . is author¢ed to note the books to show the release of this ien for
these taxes and additions.
Name of Taxpayer
?~i~i'~ . Iae.. a e~atS~a ~ ~
Residence
~L. 1~ S~s Q'j8 ' .
r~. Pi~ae.., ~Z. ~f
Unpaid Balance
Kind of Tax .Tax Period Ended Date of Assessment Ide~tifyi~g Number _ of Assessment
(a} (6) [c) (OJ ~ (s1
9ht , ~ 09-30-~9 I o~i~bo , ~ 99~~1 ~ ~a•39
JACKSONVILLE, FL.
This certificate was prepared and signed at
. on this.
the 3.Q_ day of - .19 ~
Signature ~ Title '
VAN ' CHIEF SPECIAL PROCEDURES STAFF tt
(na~ c.rrr~~cara a arker sufhwized by ~aw ro rake .cr~owr.eame.~rs rs ~or .sser~~w ro rn~ va~any a Noc~• a
F.a~.i r.x u.~ o.aM. 2e+~~. »so-~. c.e. ~2a.) ' pR~~Q ']
~ Part 3- To be used tor recordin~ ~i~VZV ~1~iE~ f~O Form 668 cRev. g781
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St. Ll~d~ C~1^d~ Cws~lAe~~ Total ;~~Z•3~
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