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Fwm 668 Dsoanment ot the Tn~sun? - Intetnd R~wnu~ S~vice
~~R~,.~.~~.,9,8, Cert*ficat~ of Release of Federat Tax Lien
District Setial Number Fo. ovrro~ar us. er R.eo.a~w onic.
~ Jaai~e~?i21~. ~leadia
565399 bk376 488 -
? I certify tbat as to ihe fdlowing-named taxpayer, the requirements of section 6:i25(a) ~J 1~;1 18 AN ~ 4 7
' of thia lntemal Revenue Cocfe have been satisfied for-the taxes listed beiow and EIt~ED LI+C F~Lfi?.^E~o
for all statutory additions. Therefore. the lien provided by Code section 6321 for st.~~c?E c4uv~ i~.
RCG4'R PGt i ii:.S
these ta~ces and additions has been reteased. The proper offiaer in the office ~t~Fr. cirCU~~ cc,;a; ~ -
whe~a the notice of iMemal ~evenue ta~c lier? was filed on Mav 10 ~ . ~
19~2_._, is authorized to note ihe books to show the release of this lien for ~
these taxes and additions. ,
Name of Taxpayer 6~131
Ma~it C~oi.l ~r Pw~ I.. dl~ftit~
~ Residence Z~a~l? Ct.
tca~t Piaaaa~. ~ 3~~tf
u~w~a e~s~~cs
Ktnd d Tax T~c Period Endsd Dats of Assesstnent tdentit~irg Number d Ass~sinent
ru ro~ c~~ ca~ a~
; lOMO l~3t-80 ~S~?~ffi 2b~-Z9-7~36 2.0~9•93
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This certificate was prepared and signed at Jackaonvi~lle, Florida m~s,
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~ the ~ th day of October 83 ~
~ Signature ' T~Q
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~ A.W. Sendlar Chief Advieor Un
Moac c.Rm~.n a a~re« .~e?~o.u.a er aw ro ak• .c~owaob~.~. a~«s.r~r.r ro~n. rarrarr a Nau~ a
~ F~Wrd Tax cr.~ a.c.r. ze~». ~aso~~. c.s. ~za.l ccc 14-7-83 ntc.
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~ Psrt 3- To be used for recording pvrposes Form ~688 (Rev. a78)
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