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Form F68 U. S. TREASURY DEVARTMFNT - INJERIJAI REVENUE SERVICE•
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tREV. Nov. i~6~t CERTIElCATE OF RELEASE OF FEDERAL TAX LIEN ~1c, ~
~ (Formerly For (Yo bs used to Relaasa Tax lians undar Sa<tion 6325(a), I.R.C. of ~954) ~'`~-3~ r
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~ OISTRICT SERIAL NUAIBER •
f JACKSdtiVIl~. ~LORIQA 1421~20
E I hereby certify that as to the fvllowing-named taxpayer the requirements of Section 6325(al, Internal '
~ Revenue Code of 1954, have been satisfied with respect to the taxes enumerated below, together with ~
` al) statutory additions provided by Sedion 6321; and that the lien for such taxes and statutory additions
~ has thereby been released. The proper officer in the of~ice where not~ee of intern4l revenue tax lien
; was filed on Januarv 23th , ~ q66, is hereby authorized to make notation an his books to show
~ the release of said lien, insofar as the lien relates to the following tdxes.
~ NA1AF OF 7AXPAYER ~ ~ -
' ~~~~ne !3 b ~ttty a~.n fipka~, ar. -
~ REbIDENCE OR PLACE OF BtJSlNE55
; t6U8 S~tth ~3t4~ Str~eL ~grt ~~.src~ Fle~ridd 334~ ~
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~ iYPE OF TRX AND PERtOD ASSESSMENT DA7E Rff-ERENCE tJO. A~~~~~
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~ 1040 I~ca~a I2-3I-~+~ 0~9~4Y•.~i3 2~x 34 ~ax3 ~ 2+~.
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~ PLACE OF fIUPlG
~ ~iISY~C! C~YC~~~ GOti~C '
I~Ci! G'$'11Q~.' TOTAI .t ~i~?'Q
Fort Plerc4, F~oxid~
WITNESS my hand at Jacksonvi t' e, Florida _ `
on rhis,
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. tfia ~h day of _February . 19 66.
DISiRIGT UIRECTOR OF INTERNAL REVENUE BY (Signature) Tir~ Chief, Snecial
~ F. S, Schmidt ProcedurPs Sec~~an
{NOT6 Gertificate of offxet authorized by law to take acknowl ent: ii nat~ssentiol to the valfdiry of thts document. G.C.M. 26414, C.B. 1950-1, 125.~
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' PART 3- e usect far reco~ding purposss 600K ~Jp 4~
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