HomeMy WebLinkAbout94-02513
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Form 666(Z) I 'I ,
IRIYB-97)
O.partm.nt 01 the Tre8lury . Internel Revenue S.rvlce
Certificate of Release of Federal Tax Lien
Olltrlcl
Serlel Number
onlc.
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I certlly thetthe lollowlng,nemed lexpeyer, under Ihe requlremenll 01 eecllon 6325 (e)
01 the Internal Revenue Cod. hea .allllled the lexea lilted below dnd all etalutory
.ddlllonl. Th.relor., the lien provided by Code lectlon 6321 lor thelD taxll and
add III on I h81 been r.leeled. The proper onlc.r In the onlce where the nollce 01
Inlernel rev.nue lex lien W81 flied on I., I
1"'1.1, II authorized 10 nole Ihe booke 10 ehow Ihe releele ollhle lien lor
Ihele lexe. and addlllonl,
Name 01 Texpayer
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Lael Day lor Unpaid S.lanc. 01
R.,lllng A.....m.nl
(e) (f)
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Kind olTax
(e)
Tax Period Ended Id.ntllylng Numb.r
(b) (c)
Dale 01
A.eellmenl
(d)
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Place 01 Filing
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This nollce was prepared and signed at
1,1; I,
, on this,
the !" I day of ,~"-_
Slgnaluro (?;,;, 'ee/ J),,..., .. ITIIIO
lNOTE C,.ftlki1/fJ 0' offlem Illilfl001t',1 tw lill\ 'Cllil~~ i1c4nm\llJdgmonls IS (lol essPI1/ljllltl !fIe \'ll/idily 0' CerM/cdto of n~le,15f1 of Fedeml Ta..llen HBV nul 71-466, HUr.2 CB. 409)
PART t . RECORDING GFFICE
FOlln lei (Zl II1IY. H7)
CAT. NO 1lOO21t
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tlForm 668 (V)
ItA.v,OCIObel 19931
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Dopartmont of Iho Troaaury . Inlornal Rovanuo Sorvlce
o
Notice of Federal Tax Lien
Serial Number
For OprlOno1l Uso by necordlng Olllcs
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/11 CC pd,
I.,
AI provided by sections 6321, 6322, ond 6323 01 Ihe Inlernol Revenue
Code, we ora giving 0 notice Iholtaxes (Including Inlerest and penaltlos)
hive been assessed agolnstlhe lollowlng,named toxpoyer. We hove mode
. demand lor psyment 01 this liability, bul II remolns unpeld, Therelore,
thlre II a lien In lovor 01 tho Unlled Stolos on all proporty and rights 10
1 property belonging to this taxpayer lor Ihe amount 01 these lexes, and
eddlllonal ponallles, Inlerest, and cosls lhat may occrue,
Name 01 Taxpayer I .
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F'TL
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Total $
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IJ I (; ".f~
Unpaid Balance ')
01 Asae88menl
(I)
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. Residence
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IMPORTANT RELEASE INFORMATION: For each assessmenlllsted below,
unless nollce of lien is rallied by the dale given in column (e), this notice shall,
on lhe day following such date, operate as a certillcate 01 release as dellned
InIRC.6325a.", .
Tax Period
Ended
(b)
~f; ,,1
(, ,I
Kind 01 Tax
(a)
Idenlllylng Number
IC)
Date 01
Assessmenl
(d)
Losl Day lor
Rellllng
(e)
Place of Filing
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This nolico was propnred and signed al
'Ihe
day 01
,1\)_.
Signaturu I-=~
lUOTE: CHIllI ,I'" l~l flU" I r ,K,l .,,,,11) I,b', 1-,' 1.,\., , ";:\',l"_hj"T'; " .
nil.. Ihll ,'1 ,Ii t. 111/1 ;' I' 11 ~I';!j
It' '!'''l.li Ie, 1I\j".ji'1111, d flul'll! 1)1 1"llma' lilll,tlll
Potl t . Kepi By Ilecordlng Olllel!
1'01111668 (V) (1lIlV. 10 GJI