HomeMy WebLinkAbout97-02776
, Dopa~lment 01 the Treasury. Inlernal Revenue Service
'arm 668 (V) (c)
:Rev. October 1993) Notice of Federal Tax Lien
District Serial Number Fa, Opl/on.IIJ.. by R,co'dlnll 011I"
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue
Code, we ora giving a notice that taxes (Including Interest and penalties) FfL
have been assessed against the fOllowlng.named taxpayer. We have made
a demand for payment of this liability, but It remains unpaid. Therefore, ( - ..:1 ()
there Is a lien In favor of the Unlled States on all property and rights to l ..... -;1
property belonging to this taxpayer for the amount of these taxes, and . ,
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additional penalties, Interest, and costs that may accrue. I " : ',-
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Name of Taxpayar f.: I~", i 'OJ, ;, j c..l ,t i ~ III;' " ( .. ~ ',(
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. llCJCOflol
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 c.u.11 13<1,:) 1lJ,
In IRC 6325(a). R;rl 13:)"1"79
Tax PerIod Date of Last Day for UnpaId Balene.
Kind of Tax Ended Identifying Number Assessment Rellllng of Assessment
(a) (b) (e) (d) (e) (f)
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Place of Filing
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ThIs notice was prepared and signed at
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the
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day of
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Signature
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(NOTE: C.rllflcall or officer authorIzed by law 10 lake acknowledQmenls Is not essenUallo the vallditv 01 Notlcl 01 Federal Tax IIln
Alv. Au!. 71.468.1871 .2 C,B. 409)
Part 1 . Kept By Recording Olllce
Form 66B (V) (c) (Rev. 10/93)
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