HomeMy WebLinkAbout96-02665
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Department 01 the Treaaury . Intarnal Revenue Service
'Form 668 (VI (c)
(Rev. October 1993)
blstrlct
Notice of Federal Tax Lien
Serial Number
For Option.' UII by Recording Ollie.
I I, . j ,1, ; ~ I"
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As provided by secllons 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a nollce that taxes (Including Interest and penalties)
have been allelled against the following-named texpoyer. We hova mode
. demend for payment of this tlsblllty, but It remains unpaid. Therefore,
there Is a lien In favor of the Unlled States on 011 property and rights to
properly belonging to this taxpayer for the amount of thesa taxes, and
addlllonal panalllas, Intarest, and costs that may accrue,
Nama of Taxpayar ' ,\, lol""! "'I',I!
Residence "nl, 1 i ! "r "1,
I,JI !'J 'i !"II ' I,: i.; d .
IMPORTANT RELEASE INFORMATION: For each assessmenl IIsled below,
unless notice of lien Is reflled by the date given In column (c), this notice shall,
on the day fOllOWing such date, opcratc as a certificate of relcase as defined
In IRC 6325(0).
Tax Period
Ended
(b)
f1'I,uo\,r1
(-\. II \:..11..,",1'
r II
"'~l< I V
Unpaid Balance
of Aesellment
(f)
Kind of Tax
(s)
Date of
Aeaassmenl
(d)
Last Day for
Reflllng
(e)
Identifying Number
(e)
1 (l.l(1 i I ..
[("") I., , : I " I (, I. . , , "
11)4'.. I . :;\ " , I , , ,
" ,
1040 1 " , ,:\ ; I I , 1. , ,!
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t.)4(J I ',;1 ! '-J I , .1, ! , "
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i.;,' 44. ',' '~,
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(",'... :",7.74
",1
,":<':).1).\
Placa of Filing
j j "Il, .11' !ll
( 'Illll,," I ,tltd ...".1
11 I, ',I,', t"
Total $ 1583')5.90
Thle notlca was prepared and signed at
~ha "".I'day'or"';' ;..- -",19_\
SlgnatureA (', ,
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61.t,.4,.t..)-r/) ........l! .~.../.. ,
(HOTEl CerUllo.l. 01 oll'ce....Ulho'l..d bV I.w to t.k. .,knowl.dgm.nllll nol ....nll.llo 111. 'IUdIlV 01 Nolle. 01 Feder.1 Tullen
Rev. Rol. 71,400, 1871 .2 c,a, 408)
Pori 1 - Kcpl By Rocordlng Orrico Form 668 (V) (0) (Rev, 10/93)
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