HomeMy WebLinkAbout97-02467
Form 660 (V) (c)
(Ruv, OctolJUr 1 DD:J)
O('p~"ll1lcnt of tho Trc::Jsury . InlcrnJI Rovenuo Scrvlco
District
Notice of Federal Tax Lien
For Optional Usa by Rocordlno Office
SCULII Number
As provldod by sections 6321, 6322, and 6323 of tho Inlernol Revenue
COdo, we ore giving 0 notlco thai taxes (Including Interest and penalties)
hove boon ossessod against tho following-named taxpayer. Wo hovo mode
D domand for paymont of this liability, bul It remains unpaid. Thorofore,
thoro Is a lion In favor of the Unltod States on 011 properly and rights to
proporly bolonglng to this taxpoyar for tha amount of those taxes, and
I additional ponaltlos, Inlorast, and costs that may accrue.
'Nama of Taxpayer II'" '", I
>'!" ,
Residence
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice 01 lien is refiled by the dale given in column (e), Ihls nolice shall,
on the day fOllowing such dale, operate as a certificate 01 release as delined
In IRC 632.5 (a):
Tax Period
Ended
(b)
Kind of Tax
(a)
Dote of
Assessment
(d)
Last Day for
Reflllng
(e)
UnpaId Balance
of Assessment
(f)
Identifying Number
(e)
Place of Filing
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This notice was prepared and signed at , on this,
,
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~,' ~'_~'''t'~~s:s :"~: 1.:':.5l'- ~..:':: :~.e ...a:,.;L!y cl tJoliClJ 01 Feceral Tax ll.n
the
day 01
,19_,
Signature
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(NOTE: Cerl,lica!B of {;l! ,:er lh.:"::;rZcj t', oJ.... t~ ld"l' Ll_"
Atv. Au!, 71.466, 1971.2 C B 4C~)
Parll . Kept [Jy RecorJlng Olflce
Form 668 (V) (c) (Rev. m93)
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