HomeMy WebLinkAbout97-03763
Form 668 (Z)
(Rlv. 5-;41
Oepartmenl ollha Treosury . Internal Revenua Service
Certificate of Release of Federal Tax Lien
District
Sarlel Number
For U.. by RoeD,dlng Ollleo
I certify thet es to the followlng.neme taxpayer, Ihe requirements of section 6325 (e)
of the Interne I Revenue Code heve been satlafled for the taxas listed balow and for
all statutory additions. Therefore, the lien provided by Code section 6321 for these
taxes and additions has been released. The proper olllcer In the olllce where the
notice of Inlernal revenue tax lien was lIIed on
19'-,--, Is In authorized to nole the books to show the release of this lien for
these texes and eddltlons
Name 01 Texpayer. ._,
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Kind of Tax
(a)
Tax Period
Ended
(b)
Identifying Number
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Date of
Assessment
(d)
Last Day lor
Rellllng
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Unpaid Balance
of Assessment
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Place of Filing
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This nOlice was prepared and signed 01
. on this.
the
day of t,;
.19-,-- .
Slgnatu,e
I Title
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(NOTE Cer""catfl 0' (I'"c" aUfhOtilBd by law,o t,Il, ,e-It,no""'eoomeMtS IS no' tSSf/nlii,"O th, Vdll111ty 01 CerMcaf. 01 R.lease 0' Fsd.ral T,r II." R,v. Rut. 11-466. r9n.2
C B 409)
PART 1 . RECORDING OFFICE
Form IDa lZ) (RIV, 5-;4)
CAT, NO 500251