HomeMy WebLinkAbout96-01494
D.p.rtm.nt of th. Tr...ury . Int.rn.l Fl.v.nu. Strvlo.
Form eea (Y) (cl Notice of Federal Tax Lien
(Rev, OctOb.,r 1993)
Olstrict Serial Number 1'0' Optlon.1 U.. by R.co,dlng Olllc.
!, ' , ~ " '. I , f'L.. ' Il,,<, \I-t((I-./ r 1l
M pro"Ided by ..cllons 8321, 8322, and 8323 at the Internal Revonue
Code. we I,. gllllng a nollc. that taxes (Including Interest and penalUes)
hl"e bltn .......d .galnst the tollowlng-named taxpayer. We have made
a demand tor payment of this liability, but It remains unpaid. Ther.tore,
th.re la I Il.n In tavor of the Unlt.d Stat.. on all property and rights to .
prop.rty belonging to thl. taxpayer for the amount of these taxes, and
Iddltlonal p.naltl.., Intere.t, .nd co.ts that may .ccru.. ,
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Name ot Taxpay.r 'A I I,
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Residence . !
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IMPORTANT RELEASE INFORMATION: For each assessment listed balow, t\ l i .L'L'\x I
unless notice at lien is rellled by the date given in column (e). this notice shall.
on th8 day tollowlng such date. operate as a certificate 01 release as defined 1,>...Io.,-t\ \~L~''''ili~
In IRC 832S(al. ~, ,,\ -""")'/"1
Tax Period Oat80t Last Day lor Unpaid Balance
KInd ofTlle Ended Identifying Number Assessment Retlllng at Msessment
(a) (b) (C) (d) (e) (f)
l:H.,' , : '. _.,_1 i , " .. ,
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Placa at Filing
f,l, , ,!: l Total $
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This notlca was pre~ared and signed at
. on this.
~th8 \),~,;; rt'd.,.of-:........-~ t.L _,~l
.19_"
, Signature A , .0",' I T,Ue .. " '. ' ,
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(NOTI: C.rtUlclle of oftl~"""uthQttUd bV law 10 takl acknowhlldgm.nls Is noll'JsenUal 10 Ih. 'I81141r1 0' Nollee or F.d.ral Tax lI.n
R_v. Rul. 71.488. 1871 . i C,8, 409)
Part 1 - Kept By Recording Office
Form 868 (Y) (c) (Rev, 10193)
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