HomeMy WebLinkAbout97-06894
Form 668 (V) (c) Dop",tmont 01 tho Trooaury . Intornol Rovonuo Sorvlce
(Rev, October 1993) Notice of Federal Tax Lien
Dlslrlct Serial Number For Optlonol U.. by Rocordlng Oil/co
I'r-i+ll' 10, I (tI,,). ((!- (r; ;5'11../
As provided by &ecllons 6321. 6322, and 6323 of Ihe Intornal Revonue F=n
Code. we are giving II nollce Ihat taxes (Including Interesl and penallles)
have been aueued against Ihe following-named taxpayer. We have made , . I
. demand for payment of Ihls lIeblllty, bul It remains unpaid. Theretoro,
there Is a lien In favor of Ihe Unlled Stales on all property and rig hIs 10
prfJperty belonging to this taxpayer for tho amount of these taxes, and
additional penalties, Interest, and costs that may accrue.
Name of Taxpayer I 1 ' .
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Residence
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IMPORTANT RELEASE INFORMATION: For each assessment listed belcw, :j\q,wrd
unless notice ot lien Is reWed by the date given In column (e). this notice shall ( \,,>1 \LI I S''7'f
on the day following such date, operate 8S a certificate of release as defined
In IRC 6325(a). ,<'14 '::>CJql'iS
. Unpllld Balance
Tax Period Dale of Last Day for
Kind ofTax Ended Idenllfylng Number Assessment Reflllng c.f Assessment
(0) (b) (e) (d) (e) (I)
: i' " I
Place at FIling
Total $
o This notice was prepared and signed at
, on ihls,
. the
day at
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Signature I Title
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(NOTfi: C.rhflcalt of of:~~8f dulhorlzed bV law to take acknowlelJQ1110n19 j~ nollf1sentlal10 Ihl) VJlidil, 0' NOllee of Fed,ral TOll lI.n
R.v, Ru!. 71.488, Ig71 .20,0,409)
Part 1 . Kepi By Recording Ottlce
Form 660 (V) (c) (Rov. 1 OI9~'
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