HomeMy WebLinkAbout97-06376
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Form 000 (V) (e)
(Il11V Oct'.,III}I 1')\),1) Notlco of Fodoral Tax Lien
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As provldod by socllon" 0~21, aa22, LInd Ga2~ of Iho 1I110rnnl /lovQnlJQ
Co do, wo oro giving 0 notice thot tLlXOS (lncllldll1U Intorout and penLlltlou)
hovo boon ossussod ogolnst thu followlllg-noJ11od toxpayor, Wo liavo mode
o domond for paymont 0' this Ilolllllty, but II romolns lInpold, Tl1oruroro,
thoru Is a lion In 'avor of tho United Stotos Oil all property ond rlgllto to
proporly belonging to Ihls taxpayor for the O11l0ll'11 0' thoso taxos, and
additional ponaltlos, InloroRl, and eosts thot moy accrllO,
Namoo'Toxpayer 1'1\111 I' ,I "11"',11111, , I"'"
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Residence "I, 111/,1 ',1111 1,11'1'.'1
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Idontlfylng Numbor
(c)
Doto at
Assossmenl'
(d)
1)<'/,00 prl '
( I lit /'113 (?
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Losl Day for Unpaid Balallc,
RoWing of AsseBSl\1enl
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IMPORTANT RELEASE INFORMATION: For each aseessmonlllsted below,
unlsss nollcs of lien Is rellled by the date given In colUmn (e), this notice shall,
on thu day following such l1ale, oporate es a cerWlcoto 01 relon5D as dellnod
In IHC 6325(0),
Tox porlod
Endod
(b)
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Kind of Tox
(B)
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Place of FIling
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Totel $
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'This notice was prepared and slgnod at i' , 11 'i I." " ,"" ,'I
, on this,
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Ihe " ',:' , day of
I).: t '1/1(11"
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Signature
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(NOTE: Certlflcato 01 alllcer BUlh\Hlzad by low 10 lako DCknawlllrJQmO/l15 hi 1101 QIUlonllollo Ulll validity 01 Notice 0' F'd"ll Tax lI.n
Aov. Aul, 11.406, lS71 .2 C.B, '109)
PorI 1 , Kopt By Rocordlno Olllco
Form 666 (V) (e) (Hov, 10/93)
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