HomeMy WebLinkAbout94-02774
: Depertment 01 the Treelury , Internel Revenue Service
Form 668 (Y)
(A.v. January 1991) Notice of Federal Tax Lien Under Internal Revenue Laws
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, For Optional Ua. by Racordlna omca
!Distrlct Serial Number
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j AI provided by sections 6321, 6322, and 6323 of the Internal Revenue Code,
'j notice Is given that taxes (Including Interest and penalties) have been
alsllsed against the followlng.named taxpayer. Demand for payment of this
I liability has been made, but It remslns unpsld. Therefore, there Is a lien In -
, favor of the United States on all property and rights to property belonging to -.
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this taxpayer for the amount of these taxes, and additional penalties, . .
Interast, and coats that may accrue.
,Name of Taxpayer r,.)
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IMPORTANT RELEASE INFORMATION: With respect to each assessmenlllsted
i below, unless notice 01 lien Is reliled by the date given In column (e), this nollce &tt 13Q3'l
shall, on the day following such date, operate as a certificate 01 release as defined
In IRC 6325(a). I'tll \OlDC"J
Tax PerIod Date of Last Day for Unpaid Balance
Kind ~: Tax En~:d Identlfyln~ Number Aeae,;ment Reflllng of AaBlaament
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This notice was prepared and signed at
,on this,
the
day of
, .19
: Signature , '. I Tille
(NOTE: Certilicate or officer authorized by law to take acknowledgments is not essential to the validity of Nollce of Federal Tax lien
Rev. Ru!. 71-466, 1971 .2 C.B. 409)
Form 668 (V) (Rev. 1.91)
Part 1 . Kept By Rocordlng Olfico
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Notice 'of Tax Lien
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