HomeMy WebLinkAbout96-06155
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form 668 (V) (c)
(Rev. October 1993)
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'Olstrlcl Serial Number
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I AI provided by ..cllons 6321, 6322, and 6323 of Iho Internal Rovenue
I Code, we are giving a nollce that taxes (Including Interest and penallles)
have beon assessed against Ihe followlng.named taxpayer. We have made
, a demand for payment oflhle lIebllllY, bul II remains unpaid. Therefore,
I there Is a lien In favor oflhe Unlled Slales on all properlY and rlghls 10
I property belonging to this taxpayer for Ihe amount (If Ihoso laxes, and
, additIonal penallldS, Inleresl, and cosls thai may accrue.
IName of Taxpayer, " , . '
IResldenca
Depa'tmont of the Treasury. Internel Revenue Sorvlce
Notice of Federal Tax Lien
For Optional Usa by Recording Olflce
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ',VI.L": \,,\
unleas notice 01 lien Is rellled by Ihe date given In column (e), this notice shall,
on the day fo~!owlng such date, operate as a cortlllcate of release as defined ( " ,-
In IRe 6325(a,. ,l.. ,\
Tax Plrlod Oale 01 Lul Day for
Kind of Till Ended Idenllfylng Number Allessmenl Rellllng
(a) (b) (e) (d) (e)
\')J:) -..lL\f
. 'c. ~,...'
-. .) _.,.) 'f
Unpaid Balancl
of Allnlmlnt
(f)
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!Place 01 FIling
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Total $
This notlee was prepared and signed at
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Ihe
d~Jof
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(NOTE: Cerllflcate 0' olllcor authorized bV law to lake DcknowledgmenU II 0011550nllal to Iho valldltv 01 Notlc. or Federal Tax II."
Rlv. Rul. 71.4ee, le71 .. a c.e. 409)
Part 1 . Kept By Recording Olflce
Form 668 (V) (c) (Rev. 1 O/9~'
Form 668(Z) Depertmenl ollhe rrlleury - Inlern.1 Revenue Servlc.
IRIV.6'67) Certificate of Release of Federal Tax Lien
Dlelrlcl Serl.1 Number For U.e bv R.cordlna Offlc.
I certify Ih.llh,'ollowlng-n.m.d I.xp.yer, under Ih. requlremenle 01 .ecllon 8325 (.)
of Ihe Inlern.1 Revenue Code h.. ..,I.f1ed Ihe lax.. lIeled below .nd ell ,'.'u'ory , I
.ddltlone. Ther,'ore. Ihe lien provided by Code IIcllon 8321 lor Iheee I.xe. .nd '1
.ddlllon. h.. been rel....d. The proper officer In Ihe office where Ih. notice 01
Inlern.1 rev.nu. lax lien w.. med on ,
, Ie .ulhorlzed 10 nole Ihe booke 10 ehow Ihe rei.... 01 Ihl. lien lor
Ih... lax.. .nd .ddltlon..
Name of Taxpay.r
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R..ld.nc.
IL 5. (,0 pd
u...~ ti 1'"1'4'5
r<~ 1I1,ql~
Kind of Tax Tax P.rlod Endad Idantlfylng Number Dalaol Leal Day for Unpaid Balanc. of
(II) (b) (c) Allallmant R.f1l1ng A.....m.nt
(d) (II) (f)
Placa 01 Filing
Tolal S
This notice wes prepared and signed al
, on Ihls,
the
day of
Slgnalura .....) I TllIa
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(NOTE: C.r!iflcatl! 0' olfle" ,ufhortHd by I."" to r,k, .Cknowledgm.nt~ I. not In,nUal to the VlJldify of C.rrl,,"r. 0' R.I.... of F~,fI1 Tax II,,, R.v. Ru/. lr""~6, ri71.2 Co. .wg)
PART 1 . ReCORDINO o"lce
Form 881 (Z) (RIV, 8.67)
CAT. NO IlJ0281