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Form 6~$ ' Deparimc==pn¢t of tflEeireasu7-inryojrrai ~npe(v~e[nSude ~er.T~ce L. t~pg <br />{Rev. SePtemoer 7976; 3+FVi l~i#"a~if~4 E71 ~6s~~~~~ VI ~Sa BA SCi ~~ @~A ~tEsC! <br />District ~ ~3--- Serial Number Fn. ~~r ~-t, Y a ,,,, r <br />- ----'---------------------.._. _i <br />1 certify tftat as to fha fioliawing-named taxpayer, the requirements of section 6325(a1 <br />of the interne{ Revenue Coda have fen sa±isfied for :he :axes listed below and <br />for alt statutory additions- Therefore, the lien arcvi~e,° b> Code section fi321 fer <br />these taxes and additions ha^s been released. The p-~q~r~~y~ff~iyy~er in *.he office <br />where the notice of interns! revenue tax lion was filed on"~~_'-~-- <br />:~ "z' ry a=~ori=ed to note the t~~:?ls tt ~`:o:c tl;e t-`e _: ~~ this !ten far , <br />;hetares ;. i additions. <br />Name of Taxpayer ---- --_' <br />? ~ t~poaa~et f~ ~~ <br />Residence !- <br />~ '' ~ <br />t~e+®nf3 T~,esad, ~ 6 <br />Unpaid Balance <br />Kind of Tax ~ Fax Period Ended iJate of Assessment Identifying Numlasr of Assessment <br />~>~ <br />This cx:rtifbcata {rues tsreparerf and segncd a: <br />tie i9t3 fi,~ NowBinbe~g 79 <br />~_-_.~ ._-_-_._i-r---~~~_~.~. <br />Totat i S ~~.1~ <br />Omaha, Nebraska <br />tan this. <br />---i Title - ~-----_... -------~-- <br />.t_ ,_-r <br />C~tald d.~ttilers Chief, Sperial Procedures Staff <br />i.Mdt:.tH 9f t#f ~ EN2~t'~.•'Rb~ Dy' iSw t.~ t~A! 8:-lTr."~~ripJy~lnprr:i iS nom. RuSM'!!MI rC iRe .31:yteSp M NPtM..p A7 <br />Tadrff Tu irn Fi-LY-26it G, P35L t, C$ t25.) <br />Para 3 - To tae used for recor~nq (wrPO+~ Lorin roe (Rev 9-7'8) <br /> <br /> <br /> <br />