HomeMy WebLinkAbout97-04305
Form 668 (V) (c) Depa"tment 01 the Treasury. Internal Revenue Service
(Rev, October t 993) Notice of Federal Tax Lien
District Serial NJmber For Opt:C'na/Use by Recording Otti,.
r\lu, q1- 4305 F7L
, As "provIded bY'sectlons 6321, 6322, and 6323 of the Internal 'Revenue
Code, we are gIving a notice that taxes (Including Interest and penalties)
have been assessed against the followlng.named taxpayer, We have made
a demand for payment of this liability, but 1\ 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
additional penalties, Interest, and costs that may accrue.
Name 01 Taxpayer
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Residence ..
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IMPORTANT RELEASE INFORMATION, For each assessmer.t listed below, \\Ct LO i\(\
unless notice of lien is reliled by the date siven In co!u!!',n (e), IhiS notice shan, <.....01 \",<,\0:-1'>::
on the day tollowing such dale, operate as a cert,f,cate of re'ease as defined
in IRC 6325(a), P-.t' 55 I ~3
Tax PerIod Date of Last Day for UnpaId ealanc.
KInd of Tax Ended IdentifyIng Number Assessment Reflllng of Assessm.nt
(a) (tJ) (e) (d) (e) (f)
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Place of Filing
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