HomeMy WebLinkAbout97-03764
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Form 66B (V) lc) Dep3'lmenl 011110 Treasury. Internal Rovenuo Sarvlco
(Rov, OctObor 1993) Notice of Federal Tax Lien
District Serial Number 1'0' Opliono, Usa by Raca,alng DilleD
f\L. q 1- 3'71..oY- F1L
As provided by secllons 6321, 6322, and 6323 01 the Internal Revenue
Code, we are giving a nollce that taxes llncludlng Interest and penallles)
have been assessed against the followlng.named taxpayer. We have made .
8 demand for payment of this liability, but It remains unpaid. Therefore, , ,
., .,
there Is 8 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 ,
addlllonal penallles, Interest, and costs that may eccrue. ,-0 --
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Name of Taxpayer ' 1
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Residence .. ,
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. n; q.o.:.> V'
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 certilicate 01 release as delined (:._v.L 1:f)~[A
In IRC 6325(a). p....t\ "i 'I ).';)'-\
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ended Idenllfylng Number Assessment Reflllng of Assessment
(a) (b) (e) (d) (e) (I)
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Place of Filing
Total $
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. This notice was prepared and signed at
. on this,
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the
day of
.19_.
Signature ::.-:~,"". ", ~ (.'. . (/ !f Title
(NOTE: Cerllllcate of oUicer authorized bV law 10 take uCknowledcrnonts I, not os~ential to tho validity uf Notice of Federal Tax lien
RIV, Rul. 71.466,1971 .2 c,e, 409)
Part I . Kept By Recording Olllco
Form 6681Y) lc) (Rev. 10/93)