HomeMy WebLinkAbout97-00952
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D.partmant 01 the Tr.aaury . Internel R.venu. Servlc.
Form 668 IV) (c)
,(Rev, October 1993)
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Notice of Federal Tax LIen
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AI provided by aectlons 6321, 6322, and 6323 01 the Internal Revenue
Code, wa are giving a notice thet taxes (Including Interest and penalties)
have been assessed against the followlng.named taxpayer. Wa have made
a demand for payment 01 this liability, but It remains unpaid, Therelore,
there Is a lien In favor 01 the United States on all property and rights to
property belonging to this taxpayar for tha amount 01 these taxes, and
I addltlollal penalties, Interest, and costs that may accrue.
IName 01 Taxpayer ,-,: ,,,I I :' .' .." - , " ,i ,
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For Opllonel Use by Recording OffiCI ,...
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice 01 lien Is reliled by the date given In column Ie), this notice shall,
on the day following such date, operate as a certificate of release as defined
In IRC 6325(a).
Tax Period
Ended
(b)
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L'-'-'"I 133.17'8
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Last Day for Unpaid Balance
Rellllng of Assessment
(e) (f)
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(NOTE: Cerllll..11 of ollle.r euthorlzed by I.w to taka a.knowl.dgmant. I. nol ...anllallo tho validity 01 NolI.1 of F.deral Ta.ltln
RIV, Rul, 71.466, 1971 .2 C,6, 409)
Part 1 . Kept By Rccordlng Office Form 668 (VI (c) (Rev, 10/93)
Kind ofTax
(B)
Identifying Number
(e)
Date of
Assessment
(d)
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iPlace 01 Filing
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This notice was prepared and signed at
the
day of
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Signature
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Total $
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Form 666(Z)
(Rev,B-i7)
Deplrtmlnt 01 thl Tre..ury . Intlrnll Revlnul Servlcl
Certificate of Release of Federal Tax Lien
Dlltrlct
For Ule RlCordln OIIlce
Serlll Number
I certify that thllollowlng.nlmed taxpayer, under tha raqulremantl ollactlon 6325 (a)
01 tha Intamal Ravanue Codl hll Iltllllld thl taxel IIltld below and all Itatutory
addltlonl. Tharelore, the lien provided by Code lactlon 6321 lor thala taxel and
addltlonl hal been relealad. The proper 0111 car In tha olllca whara tha notlca 01
Intamal revanua tax lIan wal Iliad on
. II authorlzad to nota tha booke to ehow tha releaea 01 thla lIan lor
thale taxal and addltlonl.
Name olTaxpoyer
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Relldence
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Lalt Day lor Unpaid Balance 01
Rellllng Aaaeaamant
(8) (f)
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Kind olTax
. (a)
Date 01
A.aes.ment
(d)
Tax Period Ended Identifying Number
(b) (e)
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PI.ce 01 Filing
Total
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This notice was prepared and signed at
, on this,
the
day of
Signature Of<,~!"~j~i I Tille
(NOTE: Certificate of office' autflorlzed by"w to take acknowtodgmentJ Is not essential to the VlJlidify 01 CertiflClJt. of Re/ea.. of Federal Tax lien Rr/. RuI. "''''68, 1117'.2 c.a .fog)
PART 1 . RECORDING OFFICE Fonn HI (Z) (Rev, 8-97)
CAT, NO IlOO2el