HomeMy WebLinkAbout97-01215
Form 668 (V) (c)
(Rev. October 1993)
'District
Departmlnt o.the Treasury. Internal Aevenue Service
Notice of Federal Tax Lion
Serial Number
Far Opl/on.1 Usa by R.cordlng Olflc.
AI provided by IIctlone 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (InclUding Interest and penalties)
have been a..eased against the followlng.named taxpayer. We have mode
. demand for payment of this liability, but It remains unpaid. Therefore,
there Is a lien In favor of the United States on all property and rights to
I property belonAlng to this taxpayer for the amount of these taxes, and
I additional penalties, Interest, and costs that may accrue.
,Name of Taxpayer .",
I Residence
A1, Q7-1d.15
FTL
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice 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 IRC 6325(a).
Tax Period
Ended
(b)
Kind ofTax
(a)
Date of
Assessment
(d)
({ 1\
Last Day for
Reflllng
(e)
'4 (1.38'1&
Unpaid Balance
of Assessment
(f)
Identifying Number
(c)
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Place of Filing
Total $
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This notice was prepared and signed at
, on this,
the
day of
,19_',
I
S""",,, . ~"Y_m~.~Y1 Till. . .
(NOTE: Cllllllelll 01 olllell IUlhorlud by law 10 lakl aeknowladgmlnl, I, nol ....nllallo Ihl valldlly of Nollel 01 Fldllal Tax IIln
RIV, Rul, 71.466, 1971 .2 C.B. 409)
Port 1 . Kept By Recording Office Form 668 (V) (c) (Rev, 10/93)
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