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form ~~$ ((gy~pp j ~~aDere~~P}artmc;nf$ofjtyhe fTpeasury- Ipnyt:rya! Rpevepnurea~Si~r'v{ic+eg@~ ! ry <br />(Rev. SeOtem5er797$;i B.fV~~~~iatU~L ~1 97~84~~~ U'~ ~L~`i1676 g 6DA ~i~fi <br />I7iStnGt _ YfS <br />t? <br />f~1" <br />rJBrial 1'~ <br />U cvrrlf,~y ~iilee~ <br />Fer G <br />tl <br />on <br />a~ Us <br />~ <br />RO <br />BY <br />P <br />_ <br />~ <br />[dal ! C <br />, <br />j~ <br />' <br />`~ <br />V 7 Q ~ ~ -__-,_.._._.-1 n <br />j <br />'~ <br />t <br />~ <br />~ <br />* <br />~ <br />p <br />~7"~~4ill~C7~lJ . <br />cerrtify that as to the foifowing-named taxpayer, the requirements ofi section 6325ia) <br />of the fnternat -enue ;ode have been satisfied f.?r ttts takes listed below and <br />for afi statutory additions. Therefore, tiae lien provided by Code section 6321 for ~ <br />F1e~ taX t r~ ae33itiaFs has bEcn tea. 't:?e Rt'oRer ^ffieer Irt # e office <br />~ <br />, <br />where notice ofi interne: revenue tax Tien was filed on. ~7 -~ <br />19e, is 8utttorized to note the tx~oks #a show the release of Phis lien for <br />these taxes and additions. <br />lVS.~ of Taxer <br />ife~ #~3a` HII~IIEt <br />i <br /> <br />~ Tax <br />Tau Peria9 Ended <br />Dots of Assessment ~ <br />~ <br />tdsnNfyiny Number ! Unpaid Beiet-ee <br />of Assesanent <br />ie t :~~ ~~ a t~! l t~ <br /> - <br /> f <br />~ <br />~ ~ l ~.-- <br /> ~ , <br />~. <br />> <br />T9sis e6etificaie pf+trparer3 and signed at _~_ Omaha. Tfet3rii ski _ __ _- -, , rxt this. <br />t~Siit ~y~ i3>ct,~er,1~ T9 <br />8i~us _ ! ~ r• ,?s .r i Tide <br />O~aiJ ~#'<~~:s C*ie#,S~.i,1 ~resi~~t-?s St~f# <br />txmrc ~ m , xr ~,. ~ ~. .cam s :.or .~>,~.:.a :n =.ne ~•^7,e~Y ai h~otx. or <br />F...~u r$ i.+w. rrn-ztwta, ~~Y-. ~s :rst <br />Peet 3 - To ba used hx eeoarr~ p Fa+rr+ 888 it28,+. 9x87 <br /> <br /> <br /> <br />