HomeMy WebLinkAbout96-04265
.
Form 668 (V) (0)
(RllV, Oclobor 10031
, District
D.partm.nt or th. Treuury . Inlarnal Alvlnu. Slrvle.
Notice of Federal Tax Lien
.
I'or Opl/on" Un b Reca'dlng 011I<1
Sorlol Numbor
.
I I j,
I\~" (1\.\" I.P lL L) FTL.
I
.
AI provldld by ..cllons 6321, 6322, and 6323 or tho Inlernal ReVenue
COdl, WI I" giving 0 nollce Ihsl laxes (Including Inlorusl and penalllss)
hlVI blln ....nod Igllnsl the lollowlng.named laxpayer, Ws hove made
I demand lor paymenl 01 Ihls lIablllly, but II rl",alns unpaid, There'ore,
Iherl Is I lien In Ilvor 01 Ihe Unlled 5tales on 011 property and rights to
property belonging 10 Ihls taxpayer lor Ihe amount 01 these laxos, and
Iddlllonl' penllllll, Inlerllt, and costs that may accruo,
Nama 01 Taxpayor
.
, 'I
.
, nosldence
, ,
!
.
,
"
I ,
,I'll
,
"
IMPORTANT RELEASE INFOI1MATION, For elKll "~~'!~~IlIOIlIII~leo lJulow,
un loss nollco of lion Is rolilod by IllO dalo glvon In COIUIIlIl (e), 1I11~ nolice ~l1all,
on tho day 'ollowlno such dOlo, operale us u cerlil,cule 01 release as de/mod
In IRC 6325(0 ,
Tax Porlod
Ended
(b)
'II' ,\ L '~"J I, )1. I
/" l\
II I,)~'l'i 1
4,'il(,
UnpaId Balanc.
01 Anenmenl
II)
< "
...
Kind 01 Tax
(a)
Dolo 0'
Assessment
Id)
Lasl Day lor
Rellllng
Ie)
Identifying Number
Ie)
"
...
",1
.. ,
t',.
'" I,!
, ,J
I, I.
I
I
I
I,
I.. .\
, ,
-I,'
"1
'j ',,) I
.,'I1.j 'I
I' , " :1
I Jf. . j I
I'
, ,
I
I' ./,)
, 'I
, ,
I'
'--
Place 0' FIling
\,,1
, "
Tolal S
.
i ' I I
d,' '.1 '
This nollce was prepared ilnd signed at
.
, on this,
the
..
day 01
, I
,19-...:,
51gnalUte ,
,. '.
" '
Tille
(NOTII C.r1l1lcll. of ollie., aulhotlUI3 by low 10 IQ~1I ncknowl.dgmenllll nol uliIfnllllllo thl vslldily 01 Nolle. 0' F'd",1 Tn IItn
Rov, Rul, 710466, lS71 ,2 c,e, 40e)
Pori 1 . Kept By Recording O"lce
Form 668 (V) (0) (Rev, 10/93)
.
.
.
.
.
II,
.
I'
.
"
,
.
.
!I
.
~
~
":i-
,I',
I
"
, ,
,
...9
CT
"
I,
,
\,
I
,
"
"
lh;
,
,I
, ,
"
"
"
, '
,
I '
I'll
II
'\ I'
",
, ,
~ 'I,
~ "
" I:
~ I
,
~ I ill
I
I
I
~
~ "
I \
" "
, I
" , , '
,I
"'
" "
,
,
, , 'I
" "
, 1
" I
, , ,
"
I
, I
"
"