HomeMy WebLinkAbout96-06159
form 668 (V) (c)
{Rev. October 1993)
'District
Depa-tmenl 01 the Treasury . Internal Revlnue Service
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Notice of Federal Tax LIen
Serial Number
For Optional Usa by Recording Office
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Aa provided by IOctlons 6321, 6322, and 6323 01 the Inlernal Revenue
Code, we are giving a notice Ihattaxes (Including Inleresl and penalties)
have been assessed agalnstlhe followlng.named taxpayer. We have made
a demand for payment ollhls liability, bul II remains unpaid. Therelore,
there Is a lien In favor oflhe United States on alt property and rights 10
property belonging 10 this taxpayer for Ihe amounl of Ihe" laxes, and
additional penalties, Inleresl, and costs thai may accrue.
.Name of Taxpayer i. ,
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless nollce of lien Is reflled by the date given In column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
In IRe 6325(a).
Tax Period
Ended
(b)
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Unpaid Balance
of Assessment
(f)
Kind of Tax
(a)
Idenllfylng Number
(e)
Dale 01
Assessment
(d)
Last Oay for
Rellllng
(e)
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!Place of Filing
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Total $
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iThls nollce was prepared and signed at
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(NOTE: C'It111cDII of Qfflcer authorized by'i.iw 10 take acknowledgments Is nol usenllallo the VDlldlly or Nolle. or Federal TIX Illn
R,v. Ru!' 71-46e, 1971 . a C.B. 409)
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Part 1 . Kepi By Recording Orrico
Form 668 (V) (c) (Rev. 1 O/9~'