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t <br />' � I � <br /> � I � <br /> �:. �qfut b5�. ��.6EPMIMEM OFpTHE TRCASUIff-1N1EANAl RE NUE 58RVKE �.�• . Fnr Oplionul,Ule By Remrdiag Oflia <br /> ,(R�!,ia�i) CERTINCATE:OFRELEASE`;Of FEDERAITAX.IIEN — <br /> DISI'RI , ' SERIAI NUM�DER '` ': , <br /> i�!t• ,1�bl�"ibttlC�t ;• �8504 f <br /> �- <br /> I haraby cerfify thal as to the following�named laxpayer fhe'reguiremenis of Section ' <br /> „ t3e��a)�-Ir.ternal'Revenue Code, hove lienn iaiisfied wifh respecf fo�the taxes enu•_ <br /> -+ merafed'�below,logether with,all slatutqry adtlitioni,.provided by Snction 6321;and ,'` <br />` "' tfiaf the'lien for such taxes:and statufory addifions%has fhareby been Fnleased..;The , ' <br /> ; piop�p��ice�jn Vne office where notice"of"intamal rovsnue tax lion was'filed!on � <br /> 3 ,19.t�:,is hereby authorized to Make notafion <br /> : on his books to show the release of said'lien,�insofa�,,os the lien relate!to the foilow• _ - ' <br /> - ing taxes. <br /> NAME OF TAXPAYER , <br /> �3'�'`,� +�,�4''�+�1'19 1� ��1 ,�; � { : <br /> , <br /> . � �� � i � <br /> RESIDENCE: , <br /> , <br /> �, '�'��� �.�4�� ' � i � <br /> E:. <br /> �' ' ` UNPAID BAIANCE <br /> KIND,OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT 1DENTIFYING NUM9ER OF ASSESSNIENT -. <br /> � (al ` lb)" (c� (d) . : (e' <br /> .��� �.' ��� � ~ �� ��� . <br /> .i,:s . . . . . . . <br /> PC4CE P FILV'G r��� <br /> -Qk�T��;I��b3'gBYGR �� TOTAL $ ,�J�+k��k <br /> ..-r a . . .. - . <br />' . _, . � tT 1!` . . . � . � . u � - . <br /> WITNESS.my hand ai �t��3 Nebra�ka ,on this, <br /> . . , :,: � <br /> , <br /> the 22nd day of April , 1 q 76, <br /> SIGNATURE � TITLE <br /> :.- Wm. D. �inlay Actin S ecial Procedures Offzcer <br /> (NOTEe Cerhficolo oF o�cer aulhorized 6y Ihw b taka acknowledgmenls is not esseNiol lo Ihe validily of Notice oF Fnderal Tox Lien G.C.M. <br /> 2b419,C.B, 1950-51;125,� <br /> PART 3—To bo used for roaording purpoaeg <br /> I +�i�„`' <br /> � � � � ,: <br /> . ItiM,..Si'.".. <br /> F <br /> � � � <br />