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<br />Forth 668 DEPARTMENT OF THE iREASVRr-INTERNAL REVENUE $ERV!c:E For Oplw.~a/ Use 8y Remc:ny Ofi:ce <br />(REV. 7071 } CERTifI(ATE OF RELEASE Df fEDERAt TAX 11EP1 <br />DISTRICT <br />~I SERIAL NUMBER ~ <br />_ ~C~~ f~ tl q p <br />`i `3 <br />1 hereby certi~y that as to the following-named taxpayer the requirements of Section <br />4325)x); Interne! Revenue Code, have been satis5ed with respec! to the taxes enu- <br />merated~below, together with all statutory odditions provided by Section 6321; and <br />that tha-den for such taxes and statutory additions F:as thereby been released. The <br />proper officer in the ofFce where notice of internal revznue tax lien was filed on <br />March 5 19_Z3_, is hereby authorized to rriake notafian <br />on his books to-show the release of said liars, insofar os the lien relates to the foilow- <br />iElg taxES• <br />NAME OF TAXPAYER <br /> <br />RESIDENCE ~ <br />_ ~ +. <br /> UNPAID BALANCE <br />lOND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT 1DENTIfY1NG NUMBER OF ASSESSMENT <br />(a) ib) (c) (d) (ej <br /> ~ ` <br />~~ <br />~ ~ ~ <br /> <br /> <br />n.ACF c>F HLnvG <br />~~~ TOTAL S ~~ <br />1MfTt+ESS,my harx3 at Om ha '~ehracka . on tfiis, <br />the _.u.L~1_day of_~uly t <br />StGNATLlRE ( ~-~.rrL>/~}.s~%r- I PTLE <br />Dona}~'J. Eh~er`s~`-{-" QTief, Special Procedures Staff <br />(t.F~TE: %ertp"ecate of offi:er a.:*har:z=d ^y io+v to coke ocknov.te;,+~mrts :s no' zssent:oi to the vcl~a:ry or rvo;:re of recercl lex :yen sz.~.m. <br />26»19, C.B_ i95ff-57, i25.j <br />PRAT ~-To be Tiled far recarditip pttzposes <br /> <br />J <br /> <br />