HomeMy WebLinkAbout97-00427
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Form 668 (2) !
(RIY,1-941
Ilr el
Dlplrlmlnt 01 the Trltlury . Internal Revenue Servlea
Certificate of Release of Federal Tax LIen
Slrlll Number
Olllee
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I e.rllly that alto Ihe 101l0wlng.nllllltaxpaYlr, the raqulrementl olltellon 6325 (a)
01 Ihl Internal R.vlnua Code hive betn ullllled ler tha taxel lilted below and lor
III 1IIIulory addlllona, Therelore, thl lien provided by Code eacllon 6321 lor these
taxes end addlllonl haa been released. The proper ollie.. In the olllee where the
noUCt ollntamsl revenue tax lien wee flied on I '" I . ,
111i~ Is In euthorlzed to nole Ihe books to show the release 01 this lien lor
these lexea end eddlllons
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Assessment
(d)
$ 5.co~
CJ,.lrl1.3CflLD5 p,:Il 550'&>0
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Kind 01 Tax
(8)
Tax Period
Ended
(b)
Idenlllylng Number
(e)
Last Day lor
Rellllng
(e)
Unpeld Balance
01 Assessment
(I)
.....
r.'.ll ,'1'1<-::(1 /f::~S t.':> Z(12'F.:)3',l 1:~' ~S '9~. (;1./ 24 /1)0
';J.11 ,,':;i~11/I:i6 ~':!"::"'?7:VJ.-1 J6/L~ "_Hi 1)7/17/),'-':'
q.~l '\;/31:1/,~~I,~ i.~--.:\,?-"';F{~I '.'1.:::._' l_f~/96 l<l/lfi/"/:i
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7543.23
265.70
11075.67
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Place 01 FIling
;: .-pi hq i"l ., Total
/_. 1111 \ . ,? ' . I t, 'I ',i ',~ llJ y' t. \f
$
18884,60
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This notice was prepared and signed al
, 11 i "ll" ,II. :1 '1
. on this,
lhe~ day qf I ,.1 I ".
. 19 2.:....
Signelura
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I Title
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(NOTE C'f/ll,c,le 01 (l1I'Clf lIulho,rlfd by"w,o I'~, lC~nowlfdQm,n's IS nol ,u,n/'illlO ,h, v,It(Jlfy 01 e,m/Ie'" of R,'"'' 01 Fldtfl' T.t..n R,v. RuI. 1f04H. 1011.'
Ca .09)
PART 1 . RECORDING OFFICE
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," Department 01 the Treasury. Internel Revenue Service
'Form 668 (V) (c) J
;(Rev. October 1993) Notice of Federal Tax Lien
,
, For Opl/onal Use by Recording Olllce
\Dlstrlct Serial Number
;r"l'.I" No
i I,'I;"J~I.:: ','I Villi I i\ 'i.. 3'.~I~i t q1-4dl
, A. provided by ..cllon. 6321, 6322, and 6323 of the Intarnal Ravenue FlL
,
I
J Code, we are giving a nollce that taxes (Including Interest and penalties)
J hev. been eeeen.d agelnsttha following. named taxpayer, We have made
a demand for payment of this liability, but 1\ remains unpaid, Therefore, c ~C' 'J
, ....,J ,1
there I. a lien In favor of th. United States on all property and rights to . .. !
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property belonging to thl. taxpayer for the amount of these taxes, and [.;', " ..,
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addltlonel penallles, Intere.t, and costs that may accrue. '" " 1-'1
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Name of Taxpayer ) ,
I~OVCU SUPPLY !lIe. :::\ I.:o,"r'or..;,t 1 qn c:., ,0
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\ Rasldence - .'" ' )fll
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1.l:oCHNIJ CSBUPG, fJL\ 17!)';E -l:,.:t~.'-'I In ~<
I IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~ q ,(,'l() IX'
unless notice of lien Is refiled by the date given In column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined Cu. tl 1,3<J03
In IRe 6325(a), p. tI "l ,'18'''>
Tax Period Date of Last Day for Unpeld Balanca
I Kind ofTax Ended Idenllfylng Number Assessment Reflllng of Assessment
,
I (8) (b) (e) (d) (e) (f)
I
, ,J'I1 1)'9/3(11 f3S '~'3 .';02,"J8'.i 1. 2/ ~l~,/?S 1)1.'24/1)(:) 754:1. ,,3
".4 1 0:: I '31 / '~'fu ~.'1..~~(1'273BI~ Of i 17 I (;.l.S (I"/! 11/ (.1[, 205.",70
! 1~41 f.l6/::jn/')(, L\3-~:(IL'/::!f!,?1 '/?'15/'96 HI'1.6/(.(,} 11.075.67
,
i
Place of Filing
!I,~nt hon"t ,: I.V Total $
c url\bp,.l (~n'.1 C ')Ullty 18884.60
i.: ,~t~ -I 1 sip. P i~ J ,('13
This notice was prepared and signed at
P , 1 t s t, tI t" '.111 1 P t\
, on this,
the
:.i'.'U, day of
UP C Pfjlt, f:. t"
'16
,19_.
Signature
tM
1<(~V~rllle IJff lCPt' '23-,)1-1~~5~:.
1""
Title
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(NOTE: Certlflc.'e 01 olllcer .uthorlud by I.w to '.ke ecknowledgmenllll not ....nll.I'o 'he v.lldlty 01 NoUce 01 Federal TaxUen
Rev, Rut, 71.466. 1971 .2 C,B. 409)
Part 1 . Kept By Recording Office
Form 668 (V) (c) (Rev. 10/93)
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