HomeMy WebLinkAbout97-03771
Dopa-Imonl 01 Iho Troasury. Intornal novonuo Sorvlco
Form 66B (V) (c)
(Rev, October 19931
District
Notice of Federal Tax Lien
Serial Number
As provided by secllons 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a nollce that taxes (Including Interest and penallles)
have been assessed against the followlng.named taxpayer. We have made
B demand for payment of this liability, but It remains unpaid. Therefore,
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
addlllonal penallles, Interest, and costs that may accrue.
Name of Taxpayer
\
Residence
I
Fa' Optional Usa by Roco,dlng Oil/co _
/\10. ql- 3'-/1 I
"
, "
I=TL
,".,
6,
,
...
r'
,..,
IMPORTANT RELEASE INFORMATION: For each assessment Iisled below,
unless notice of lien Is refiled by the date given In column (e). this nolice shall,
on the day fallowing such dale, operate as a certificate of release as defined
In IRC 6325(a).
Tax Period
Ended
(b)
...q .LJofd
,-,-\;1\ \'>1)5;;91
~-tl 5<l:l:;,
Last Day for UnpaId Balance
Rellllng of Assessment
(e) (f)
Kind of Tax
(a)
Idenllfylng Number
(c)
Date of
Assessment
(d)
,Place of Filing
This nollce was prepared and signed at
.the
day of
,19_.
Signature
tN!..~.J';;>, /i? ('~.:: ,".' Title
::/
...
...
...
..
~
"
--
.
Total $ .
.
. on this,
.
"'"
"1'
(NOTE: Certlflcate 01 Dlflcer authorized bV law 10 take acknowleaQrnenls Is not essential to the validity 0' Notice 01 Federal Tax IIln
Rlv. Rul. 71.466.1971 .2 c,e, 409)
Part 1 . Kept By Recording Office
Form 668 (V) (c) (Rev. 10193)
,
...
.
--
.-,
\
.-
. 'Z.
0
... '9
. I ,
~
...:J
-
.,
...
.
!
.
,
I
. !
I
, . I
I
.. I
I
'.,,'" I
I'
.
I
...../
'f. ~
.~...J
.......,
..
Form 668(Z) 4 'I I
(nO\lo'\)1I
Deportment of the Treasury. Internal Aevenua Service
Certificate of Release of Federal Tax Lien
Olstrlct
Serial Number
For Use by Aecordlng Olllce
pum'>Yl.VANIII ~'II 'll',.'
I certify thol the followlng.nomed taxpayer, under the requirements of section 6325 (0)
of the Internal Revenue Code hos setlsfled the laxes tlsted below ond all statutory
additions. Therefore, the lien provided by Code section 6321 lor these taxes and
additions has been released. The proper olllcer In the olllce where the notice 01
Internal revenue tax tlen wasllled on _"..'__.__:l,.'..!,.:'-I'L-,-----------,
____,L'),~Z, Is authorized to note the books to show the release 01 this tlen lor
these taxes and additions.
Name of Taxpayar
')^,,'E~. I ,~ VIet I l. IIUL':.r
"., () <')
I ~;.t ..
'-:J
ii' : 'I ."j
I. . -") ( 'j"
I rn
i .....)
L", '" ~,~ (:)
t~. .: ( "Tl ',Jj
,;( ::1: "1.:-
;()
:.':( S.? ~~jlll
.~. ( :;:'t
:"3 :..> :jj
-. .-1 -<
Aasldence
6~ flLGENCY S
I'MiLl':,Jr. 1'1\ Till!'! 1I.I'P
-u 5.eu (I
Cu..t\ \y1'/'l,
Libel'
Tl/il
Pa~lP
nla
COUfll RllOH~ING INf0PMII1IUN:
lire No, S~rial No.
n/a Q!..377IFll.
Tax PerIod Ended Identifying Number
(b) (c)
Date 01
Assessment
(d)
f1 Ii ,4l,o'3
Last Day lor Unpaid Balance 01
Rellllng Assessment
(e) (f)
Kind 01 Tax
(a)
1040 17/31/1994 116-50-5233 U6/12/19~5 n7/12/2005 5365.95
....... "",., .... .,. .., .A" .It. ,.... ... .",,1.,""" A..' ....,..... ,....... ............
Place of Filing
P r' 01:. h (I n n t .;t ,~ v
Cumbel"land COIJtltv
Cn,") i~, if' lJA 7(\.{
Total
$
586~,95
This notice was prepared and signed at
Pilt~,t."H'(lh. jl(~
, on this,
the
:.:nlhdayof Nov"",b",.
ll)":~
Signaluro
ITitIO
" \ H] f" ~, ': I.' r~
(NOTE. eNtlfle,11ft 01 ,,",cor atllhorr/ed by law to ',"9 aChnowledgmonlS is nol llSSenlilJl 10 the v.ll/{'My of CerlifiC'altJ of Rele.1Sfl of Foder,,1 Tax t'tm Rev. Rul. 7r-466. 19".2 CB. .,09'
/1
, .
! ~. 1
.'
PART I . RECORDING OFFICE
Form 668 (Z) (Aav. 8-97)
CAT. NO 60026\