HomeMy WebLinkAbout96-04046
Oeplrlment 01 the rreolury . Intlrnol Revenue Service
Form 668 (Y) (e)
(Rev, October 1003)
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Notice of Federal Tax Lien
Dlslrlct l Serial NU"~JU/' For Opl/one' Un by Recordlno 01/1..
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AI provided by IUctlons 6321, 6322, ond 6323 of 1110 Intornol Revonue \,l~), L\lAli, ~lL.
Code, we 8r8 giving 8 notice that tox08 (Including Interost ond penalties)
hive been eU88sed 8golnlt the followlng.nomerltoxpoyor. We hove mode , , ,
I demond for psyment of this lIoblllty, but It remoln8 unpold. Therefore, , "
there II . lien In levor at the United Stoles on 011 property ond rights to ,
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property belonging to thll toxpoyer lor tile omount 01 those toxos, ond ,
Iddltlonel peneltlee, Interost, end costs thot moy occruo. " :,'1
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Neme of Taxpayer , , ' ,
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Residence "I
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IMPORTANT RELEASE INFORMATION: For eacl1 assossmel1t listed bulow. 1/ 'I,:.) r"'/
unles5 notice 01 lien 15 reWed by tile dale glvel1ll1 CO'UI11I1 (e). thiS 110llce s'1all, .." ,I /.')>('1'1S
on the day lollowlng sucl1 date. operate us 0 certlllcate 01 reloase as dolll1ed
InlRC 6326(a), ,;" I-j I(),'j'~
Tex Period Dato of Lost Doy lor Unplld Blllnoe
Kind 01 Tax Endod Identifying Number Assessment Rotlllng 01 Aueument
(a) (b) (e) (d) (e) (f)
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Itl'ill I ' 1/'11 II'j' -lot 1,1,111 1l."ll I"! ". ,'I,I,il,'; I 1.11 . " (,
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Place 01 FIling
l'l'u 1:.11 o t'l ',I 1,;11 "I Totol S
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This notice was prepared and signed at I,'", I .,d" I L' I. I... 1"1\
, on this,
,the .' It' I, day of
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Signature f ,.. \ .r I Tille 1'1. " ..,'"
,/~I'{j',l"ll:)"'II'lt,~~,..:-.\)l..~\-./\i\.':~ , ")\111.1111 .
(NOTI: C"llllcal. 01 Offlc.r authorized by law 10 lake ocknowllt\.lgm.n!s IS nol nsenllallo the validity of Nolle. or Fld"el rlX IIln
RIV, Au!, 71.400, 1971 ,2 C,B, 409)
Port 1 ' Kept By Recording Ofllce
Form 6BB (V) (e) (Rev, 10/93) .
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