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-.- 1 ~ /~
~ 668
(Rev. 8eptembe~ 1978)
~IS~Ct
JACKSONVILLE
DepaAmsnt ot the Treasury - Intem~l R~venue Service
Certificate of Release of Federal Tax Lien
Serial Number C~~ Fo~ OpHona/ Us~ gr R~cordk~y OfMe~
300637 bk-236 pg-169 ~~6 13 ~I !Q ~5
1 ce~tify that as to the following-named taxpayer~ the requirements of section 6325(a) S `EUC E~CG1~~ TY f t~A.
of the intemal Revenue Code have been setisfied for the taxes listed below and ~OGER P~ITR~S
for all statutory additions. Therefore. the lien provided by Code section 6321 for CIERK CIRCUIi C.R~R'_Q
the9e taxes and additions has been released. The proper oHicer in the office .~ ~rar. rs ~r~ ~~ .~- ~
where the notice of intemai revenue tax lien was filed on Fef+nal~t-~r~
19.~._, is authorized to note the books to show the release of this lien for
these taxes and additions. SisB~
Name of Taxpayer
Harold Bickelhaupt
B. ~ B. Excavatin~ Contractor
Residence
, 4750 II. S. I
F~ Pierce_ F1 ~~4 511
Unpaid Balance
Kind oi Tax Tax Period Ended Date of Assessment Identifying Number of Assessment
(aJ (b) (e) (d) (e)
2290 06-3U-74 11-04•74 59-1431846 234.14
2290 06-30-75 11-04-74 " 176.67
Place of Fiting
CLERK, CIRCUIT COURT
ST, LUCIE COUNI'Y TOtel = 401, 81
, PT. PIERCE, FL.
This certificate was prepared and signed at ,Tnck~envi 11 e_ Al eri da . on this. '
the 3~ ~ty of Februa~,~9 $1 =
/
signature ~ f Title .
n
'' Chief_ Svecial Procedurea Staff ~
(Not~: CerfHkats ol Wflcer ~uthwized by law taks ~clcnowledpmenfs /s ~~~i~ fo the ~~~o/ Notice oI
Federa! i~: Uen O.C.AI_ 2M19, f9541, C.B. 12b.) ~~
J
~ ~~ p~~ Fc~r 668 (Rev. g78}
~ Part 3- To be used for recording purposes
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