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HomeMy WebLinkAbout97-05097 Form 668 (V) (c) Dopo.tmont 01 the Troosu,y . Illlornol Rovonuo S.,vlc. (Rev, Octobe, 1993) Notice of Federal Tax Lien Ditlriet Serial Numbe, Fa' Optional U" ~y RlCordlng Olllc, f\\ C), l( rl., 5DC! 7 At provided by IIcllont 6321. 6322, end 6323 of thl Inte,nel Revenue e, .,...., rTL I. .) COdl, we I,. giving I notlcl that taxes (Including Interest and penalties) ~ -' " h.v. bltn a......d Igelnst th. followlng,named taxpayer, We hev. me de " , I,' , '1 I d.mlnd for p.ym.nt of thle liability, but It remllns unpeld, Therefore, '-', " \11 'r th.1I II I lI.n In favor of th. United Stet.. on ell property Ind rights to ".. "") ~". .' .r.' plop.rty b.longlng to this texpayer for th. emount of these taxes, end , .,)) , . Iddltlonal p.neltl.., Interest, end costs that may eccrue, 'J ~ : ~~ I ! ~., -- ~.'.' :.:y." Name 01 Taxpayer ,I f:.. "J .. , __J :...J ...,; Residence , IMPORTANT RELEASE INFORMATION: For each assessment listed below, llq.LQI"I unless notice of lien Is retlled by the date given in column (e). this notice shall, on the day 10~\~Wlng such date, operate as a ce,1illcate of release as de lined ~;.. s, H\.A:1::J ~ In IRC 6325 a ' ~ti f)uut4'z; T.x Period Dete 01 Lest Day for Unp.ld 8.I.nel Kind of Tax Ended Identifying Number Assessment R.tlllng of A.....m.nt (B) (b) (e) (d) (e) (I) , " , , : , , '" , , i' : : " : , , : : , , " " Place of FIling Totel $ - ",. ,.. ",. .. " . .. . ,.... ..'" ,..It .... ... .... .. . .. .. This notice was prepared and signed at , on this, "" the day 01 ,19_, "" Signature /) \ Tille V,;(~L/;J .' -, - I -- (NOTI: C.rtlflcat. ot olHe.r QulhOrlud bylaW to l..lke at;IHloW\ttJ~l1\ftr1tll'S not u,,,nll,Jllo lhi valitlilj (,II Nolle. of F.d,ral TI)( lien "ov, "ul, 11,.8e, lall " C,8, 40~) ParI 1 ' Kept By Recording Olflce Fo,m 668 (V) (0) (Rev, 1 0/9~' ....., ,-" . Form eee(Z) , Olplrtmlnl 01 Ihl Trellury , 11I1.rnll Rlv.nul Slrvlcl (Reve,S7) Certificate of Release of Federal Tax Lien Olllrlcl Serl.1 Numb.r For U.. bv R.cordlna OHlc. . - I c.rtlfy ,h."h. lollowlng-n.mld I.xp.yer, under Ih. requlremenll 01 .<<lIon 6325 (Ii oflhe Inlernel R.venue Code h.. ..II.II.d Ihe lu.. 1I.,.d below .nd .11 ,','u,ory .ddlllon.. Th.r.for., Ih. lI.n provld.d by Cod. ..cllon 6321 lor Ih... lu.. .nd .ddlllon. h.. bien r.'....d, Th. proper oHlc.r In Ih. oHlc. wher. Ih. nolle. 01 Inl.rn.1 rev.nu. IU lI.n w.. m.d on .. ..--.-...._-. ++_u._____ , C \ \." , ,n.., _...._~., I. .ulhorlz.d 10 nol. Ihe book. 10 .how Ih. r.I.... 01 Ihl. lI.n lor " l.! " . Ihll. I.x.. .nd .ddlllon., ~I ) , (I'.. ~. J - " N.m. 01 Tup.y.r ('(" , I ,I '. . , '. .' " " . R..ldence . . " ).- , VI ~ , , . - ,;,"nJ " :) , 1~5 .... \ 0 ..' " .. .\.J..:l ~j( I : i I ~, i . , . ' ;1 I " tv... 1,\ 1'\-IC;.,u " , . 'I" -, " ,..... ,pQ<l/3 Kind on.x r.x P.rlod End.d Id.nllfylng Number 0.,. of LI., o.y lor Unp.ld B,'.ne. of (.) (b) (c) A.....m.nl R.f11lng A.....m.nl (d) (e) (f) , . . " , . " . . .' . ., , . , , PI.e. 01 Filing TolIl . " " . This nollce was prepared and signed at nO , on Ihll, the ~.._ day 01 __,__ , --' , . Slgn.lure" -<)" I .. _ I Till. IW"""-"r""'" .ulhOl'",d bv ,",w '" ,..,. oc,no.,.dum.""" no' '''''''''''0> ,n. "lId'ly 0' Corll"".,. 01 R.'..... 0>' '......,~. '.n RON,/M ,,-. t871,zC.& 4IlII} 'AAT I . ~ICOAOINO O"ICI 'a,m 11I12) (,..", .t7) CAT. NO__I