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Form ~68 DePartment of the Treasury - Internal Revenue Service
(Rev September 1978? Certificate of Release of Federal Tax Lien
District Serial Number 5 ~ 72gg Fa Optional Use by Recording Ollice
~~u~• BK 382 PG 1768
I certify that as to the following-named taxpayer, the requirements of section 6325(a) ~i~
of the lnternal Revenue Code have been satisfied for the iaxes listed below and for
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all statutory additions. Therefore, the lien provided by Code section 6321 for these 3~~~• j ~t~ ~
taxes and additions has been released. The proper officer in the office where the 9~•
notice of internal revenue tax lien was filed on August 25 , 19 82 i~ e,~~
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is authorized to note the books to show the release of this lien for these taxes and ~ 1-+.,
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additions. ' - . ~
Name of Taxpayer
I~alre~os 5he~'MOOd ~iedgee ~ gPT
Residence ~ ~ ~~.~QL~
~'oa't Pierce, ~'laeimt 33~5~
Unpald Balance
i Kind of Tax Tax Period Ended Date of Assessment Identitying Number of Assessment
~ (a) (bl fc) (d) (e)
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i ~}i ~2 ~~Z Q~~~S7iZ ~"v7v~a-~c+~ OC}4.'~f~
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~ Place of Filing ~1~ G.~it CORil~
~ Foact Pi~ac~c~ Cqffity Cotirt~se Total a '
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a~t Pi~rres, Flaacida 334~ '
This certificate was prepared and s~gned at JacksonvilZe, Florida ,on this,
' 4th August 83
: the day of ,19
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Signature Title Nit
~ a~~c Pa~E ~
' ~ . W. Sendler Chief, Advisory Unit -
(Note: Ceitilicate c. icer a~ i ~M~V''te fake acknow/edgments ~s no[ esse~tial to the validity Notice of
Federal Tax lien G.C.M. 26419, 1950-J, C.B. 125.)
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Part 3- To be used for recording purposes ~orm 668(Rev.9-78)
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