HomeMy WebLinkAbout97-01217
Department of the Treasury. Internal Revenue Servlc.
Form 668 (V) (e)
(Rev. October 1993)
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For Opllonal U.. by Recording Office
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Notice of Federal Tax Lien
Serial Number
i As provided by sections 6321, 6322, and 6323 of the Internal Revenue
i Code, we are giving a notice thet taxes (Including Interest end penalties)
'1 have been auessed against the followlng.named taxpayer. We hava made
I a demand for payment of this liability, but It remains unpaid, Tharefore,
I there Is a lien In favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
I addltlenal penalties, Interest, and costs that may accrue,
Name of Taxpayer
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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
In IRC 6325(a),
Tex Period
Ended
(b)
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Kind ofTax
(a)
Date of
Assessl'1ent
(d)
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Last Day for
Reflllng
(e)
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Unpaid Balance
of Assessment
(f)
Identifying Number
(c)
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This notice was prepared and signed at
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Total $
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(NOTE: Corlllle.to of offleor .uthorlnd by law 10 lak. .eknowl.dgm,nlS I. nol ....nll.llo Ih. v.lldlly of Nolleo of Fodor.1 Tax Il.n
Aov. Au!. 71.499,1971 .2 c.e, 409)
Pert 1 . Kept By Recording Office Form 668 (V) (e) (Rev, 10/93)