HomeMy WebLinkAbout96-06160
Depa"mon' ollhe Treasury - Internal Rovenue Service
Notice of Federal Tax Lien
rm 668 tV) (c)
;t>.ev. October 1993)
;Olslrlcl
Serial Number
As provided by secllons 6321, 6322, and 6323 01 Ihe Inlernal Revenue
Code, we are givIng a nollce Ihat taxes (Including Inlerest and penallles)
have been assessed against the following-named laxpayer. We have made
a damand for payment of this lIablllly, but II remains unpaid. Therefore,
there Is a lIan In favor oflhe Un lied States on all properly and rights 10
property belongIng to this taxpayer for the amounl of Ihese laxes, and
additIonal penallles, Inleresl, and cosls that may accrue.
Name 01 Taxpayer
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Residence
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For Opl/onal Usa by Racordlng Olllce
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IMPORTANT RELEASE INFORMATION: For each assessmenlllsted below,
unless nollce of lien Is refiled by the date given In column (e), this notice shall,
on Ihe day following such date, operate es a certificate of release as defined
In IRC 6325(a).
Tax Period
Ended
(b)
l\ q. 00 IX\
(,,,\ I :;.2 ~C\'+
1'-1\ '1'5 :)L;;c.i
Last Oay lor UnpaId Balance
Rellllng of Assessment
(e) If)
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I Kind oITax
I (a)
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Oale 01
Assessmenl
(d)
Idenllfylng Number
(e)
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Place of FIling
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Totel $
This nollce was prepared and signed at ' on Ihls,
Ihe day 01 ,19_.
S"o~.J.Z j /.,; ... /.- '; '1"'"
Part 1 . KepI By Recording Olllee
(NOTE: C.rllllc811 01 otfle., authorized b~ Ii'w to take acknowledgn,enls Is nol nsantlallo thl validity 0' NollCl of F.deral Tax Illn
Rlv. Rul. 710466. 1e?1 . a C.B. i09)
Form 668 (V) (c) (Rev. 1 O/9~'