HomeMy WebLinkAbout97-02478
Form 668 (V) (c)
(Rev. October 1993)
Oopo-Imont of the Treo.ury - Inlornol Revenuo Service
Notice of Federal Tax Lien
District
Serial Number
For Optional Uso by Raco/dlng Ofllc,
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As provided by sections 6321, 6322, and 6323 of the Internol Revenue
Code, we are giving a notice that taxes (Including Interest and penoltles)
have been assessed against tho followlng-nomed toxpayer, We have made
a demand for payment 01 this liability, but It remolns unpold. Thorefore,
there Is a lien In favor of tha United States on all property and rights to
I property belonging to this taxpayer for tho amount of these taxes, and
additional penalties, Interest, and costs that may accrue,
Name of Taxpayer,;
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IMPORTANT RELEASE INFORMATION: For e;:lch assessment listed below,
unless notice of lien is rellled by the date given In column (e), thiS nQtice shall,
on the day following such date, operate ;:IS a certificate of release as defined
In IRC 6325(a).
Tax Period
Ended
(b)
Kind of Tax
(a)
Date of
Assessment
Id)
'illiCo'LJ\>c1
Cl..l.1\ \ ""'.'r IlP~
f{" '~I Cj '>'-1
Last Day for Unpaid Balance
ReHling of Assessment
(e) (t)
Identifying Number
Ie)
Place of Filing
Total $
This notice was prepared and signed at
, on this,
the day of
19_
Signature
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(NOTE: Clrt,licate 01 c!!.~or aulhorllciJ liy iJ.,...lo la~_e u.....r ;,....~,:~:.-,u.'I).S rcl t1"'~t'!.~~ i1: Iv \'\0 ..a~ iJd" 01 N.jliCl 01 Fedoral T8.ll. lien
Rtv. Au!. 71.466, 1971 .2 C.I). 4C9)
Part 1 - Kopt By Recording Orrlce
Form 668 (V) (c) (Rev. 10:93)
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