HomeMy WebLinkAbout94-02009
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Form 668 (V)
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Depertment of the Treesury - Internel Revenue Service
Notice of Federal Tax Lien
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District
Serial Number
For Options I Usa by Recording Olllce
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AI provided by sections 6321, 6322, and 6323 of the Internal Revenue
Code, we ere giving a notice that taxes (Including Interest and penalties)
have been ~uessed against the following-named taxpayer. We have made
a demand for payment of this liability, but It remains unpaid. Therefore,
there II 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 penaltlel, Intereat, and costs that may accrue.
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice 01 lien Is reliled by the date given In column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
In IRC 6325 a).
Tax Period
Ended
(b)
Kind of Tax
(a)
Identifying Number
(c)
Date of
Assessment
(d)
dlq.oo
Last Day for
Reflllng
(e)
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~~995
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Unpaid Balance,
of Assessment
(f)
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'Place of Filing
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Total $
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This notice was prepared and signed at
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........
, on this,
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the
',I', day of
Ar,'" , I
,19~t.
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Signature
Title
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(NOTE: Cerlilicale of officer' aulh'""o',IZ-od by law to take acknowludgments is not ossential to the validity 01 Notice of Federal Tax lien
Rov, Ru!. 71.466, 1971 .2 c,e, 409)
Part 1 . Kept By Recording Office Form 668 (Y) (Rev. 10.93)
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Form 668 (Z)
(Re' 6-94)
Dlslrlcl
Deparlmenl ollha Treasury. Inlernal Revenue Service
Certificate of Release of Federal Tax Lien
Serial Number
For Use by Recording Olllee
I certlly Ihol oe 10 Ihe loll owing-noma lexpayer, Ihe requlremenls 01 eecllon 6325 (0)
ollho Inlernel Revenue Code hove been sallsllod lor Ihe laxes IIsled below and lor
011 slolulory eddlllons. Therelore, Ihe lien provided by Code secllon 6321 lor Ihese
laxes and eddlllone has baen released. The proper ollleer In Ihll olllce where Ihe
no lice ollnlernal revenue lox lien was lIIed on !
19 --' Is In eulhorlzed 10 nole Iho books 10 show Ihe release 01 Ihls lien lor
Ihese laxes and addlllons
Nome 01 Taxpayer p
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Lasl Day lor Unpaid Balance
Rellllng 01 Assessmenl
(e) (f)
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Kind 01 Tax
(0)
Tax Period
Ended
(bl
Dale 01
Assessmenl
(d)
Idenlilying Number
(c)
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Place 01 Filing
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This nOlic& was preparod and signed 01
t on this,
Ihe
day 01
.19_,
I Tille
(NOTE: CertJf/cato of oftlcet duthotizedby I.Jw'O '03,,"0 .1cll.no""cc1gments is no, essuntia' 10 me ~'iJfdlty 01 Cenlflc.3le"uf Reluaso 01 F0d6fJI TaK lien Rev. Rul. 71.466 191f.2
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PART 1 . RECORDING OFFICE Form eee (Z) (Rev. 6-94)
CAT. NO tlOO261
Signalure
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