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F'Jm 668 (V) (c) Deportment at the Treosury - Inlernol Revenue Service
( ""', August 1 997) Notice of Federal Tax Lien
I etrlct Serlol Number For Opllon,' Us, by R'cnrrJlng omc.
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~ U,lI'li..', ,~ \/ :j,i- , ' No, q't?-lJlq'l
,.s provided by sections 6321, 6322, and 6323 of the Internal Revenue FTL
~ode, we are giving a notlca that taxes (Including Interest and penalties)
sve been assessed against the following-named taxpayer. We have made ( .~.: ,0 ,.,
demand for psyment of this liability, but It remains unpaid. Therefore, ' . C.') ~ i ",
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there Is a lien In favor of the United States on all property Hnd rights to -"'1' "'-j "r'!
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property belonging to this taxpayer for the amount of these taxes, and I .-::r1
additional penalties, Interest, and costs that may accrue. u~ .\..:J
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Neme ofTexpeyer '",I .-, "-11
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IMPORTANT RELEASE INFORMATION: For each assessment IIstsd below, -I>q,OO~
unless notice ot lien Is rellled by the date given In column (e), this notice shall, c..v..:t! \4IQ'15
on the day following such date, operate as a certificate of release as defined In
IRC 6325(8). fl-..I ~,q~1
Kind ofTax Tax Period Ended Identifying Number Date ot La.t Day for Unpaid Balanc. at
(II) ,," (b) (c) A.....m.nt R.tlllng A.....m.nt
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IThlS notice was prepared and signed at
(he ":' day of
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(NOTE: Corlificato of officer oulhorlzod by /iJW to tahe aclmowledg. ts Is not essential to tho validity of Notico of Fedeml TiUl'lien Rov. Rul. 71-466, 1971.2 C.B. 409)
PART 1 . KEPT 8'1' RECOR01NG OFFICI!
FD"" ses M (D) (Rev, e,97)
CAT. NO e0025X
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