HomeMy WebLinkAbout96-01371
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11'" Dep.rtm.nt ollhe Treuury - Inl.tn.1 R.venu. Servloe
Form sea (V) (c) Notice of Federal Tax lien
(Rev. October 1993)
District Serial NumDer Fo, Optlon.IV.. by Roco,dlng 011I<1
F't, ! I ~ J ~ I ~,h I ,i " " , /~'-' . Qlc-1371
A. provld.d by ..ctlons 8321, 8322, and 8323 of the Int.rnal R.venu. rTL
! Cod., w. .r. giving. noUc. that laxe. (Including Interest and p.naIU.s)
i IlIv, b..n .......d .galn.t the followlng-nam.d taxpayer, We have mad.
I . demand for p.yment of thl. liability, but It remains unpaid. Ther.for.,
tilt'" I. . lI.n In favor of the Unlt.d States on all property and rights to .
1 property b,'onglng to thl. t.xp.y.r for th. amount of th... taxes, and .. ,
.ddltlon.1 p.n'IU", Inter..t, .nd cost. that may .ecru..
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N.m. of Taxpayer 141LLIAM I~ ill., -~ I
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i Resldenc. -~~.4'J "n JOHN:; DF', . ,
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I CAMP HILL, Pol 171) 11 - 1< ..I
, IMPORTANT RELEASE INFORMATION: For each assessment listed Delow, t. ~ r. \..X,.,; \4..'
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i unl.ss noUc. of lI.n Is retlled by the date given in column (e). this notice shall,
on the day following such date, operate as a certificate at release as defined ...., \..~. ,ii 1:J'ji-j\i-~
In IRC 8325(8). I<t! "'-.I...:..~' I
Tax P.rlod Date of Last Day for Unpaid Balanc.
KInd onlll Ended Idenllfylng Numb.r Assessm.nt R.flllng of A.....m.nt
(., (b) (C) (d) (a) (f)
104(J t::'/31/9j .::ai-<:'u. 4';;)':--; i I.,'~j.. .~ -~ ,"..t. (-),:/.' ~.': ,.. I , -l .~,sI'::'.. e.-r
Place of Filing
F'r,) "'1"1':'(1" t.l.'- ",
(' I ~Iil i! c~ t 1l.ft .'j \ ~ ') I ( r, t , Total S ..::':. ,"':,'. ;::7
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This notice was prepared and signed at
, on this.
,. ..:., h;'d'a' 'y""'O.f. -'7 "n~t'T.fll"""
the . 19_~
SlgnatI-J~~~,1'..r~,...j;. " "
Title
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(NOTI: Certlllcate 01 elfletr aulhOflUG by law fo lalt, acknowllijgmlnl1 is not ,,"ential to the validitv or Nollel 0' Fldlral Tax Uln
Rev, Rul. 11.4ee, 1911 ' Z C.B. 409)
Part 1 - Kept By Recording OttIce
Form 868 (V) (c) (Rev.l0/93l
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Form 668(2) Department 0' Ihe Treeaury . Inlernal Revenue Service
rR..a-91j Certificate of Release of Federal Tax Lien
Oletrlct Serlel Number For U.. bv Recordlno OffIu
I c.rtlfy that th.lollowlng-nemed taxpayer, under the requlrementa of Hetlen 6325 (.)
of the InI.rn.1 R.v.nue Code hu ull.lled Ih. tax.. Ulled below Ind .U ltatulory
Iddlllon., Ther.lore, the Illn provided by Code Hellon 6321 lor lhe.. Iell.. Ind
Iddlllon. h.. been r.l.ned, The proper offlc.r In Ih. offlc. where Ih. notlc. of ( .
Inl.rn.1 rev.nu. tax ltan WI. flied on ,
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. I. .ulhorlzed to nol. the boOkl 10 Ihow Ih. rei.... 0' thll lI.n lor -
r
the.. taxe. Ind .ddltlon.. ,
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N.me 0' Tupeyer ,
R..ldenc. .' "
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Kind ofTex Tex Period Ended ldenllfylng Number o.t. of La.1 Day lor Unpaid "'Iance of
(a) (b) (c) A.....m.nl Raflllng A.....ment
(d) (a) (f)
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Plec. of Filing
Total S
This notice was prepared and signed al
. on this,
the
day 01
Slgnalllre
I Tille
(NOTE: Cfff1Ik:ate 0' officer lIurhoflnd by lifW to ra,.. iJ'Jmo~I.av-.,nrlll(' " not lS.,entJal fO mil li4litM't Qf CtlfMcJttl of Retlll,UII of FfllMn1l Tu l/fln R.", RuJ. "-46d, '9".3 ca 4CfIJ
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PART I . RECORDING OFFICE
Fom! III (Z) 1_ "11)
CAT. NO IOCl2Il