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Form 668 (Z)
(R,.. S.tj41
Deportment olthe Treasury. Internal Revenuo Service
Certificate of Release of Federal Tax Lien
Dlatrlct
Serial Number
For U.. by R.cordlng 011I..
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I certify thet es to the lollowlng,nemo texpayer, tha requirements 01 aectlon 6325 (a)
01 tho Internal Revenue Code h~ve been ..tlalled lor the taxea lIated below and lor
011 atotulory oddltlona. Therelore, the lien provided by Code IIctlon 6321 lor these
texll and addltlona haa been released. The proper olllcer In the olllce where the
notice 01 Internal revenuo tax lion was tiled on ' " , , , ". I
19 ~ la In authorized to note the booka to ahow the rolea.. olthla lien lor
thelD tn~es and additions
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,'lP __dl,My 0' Ct'rJifl,.IfU 0' Release 0' FfJd.'~' T.. '.n R.v, RuI. 1f.466. '911.2
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P^RT 1 . nEConOItlG OFFICE
FD<m eea (Z) (Rev, 6-;4)
CAT, NO 600281