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HomeMy WebLinkAbout94-04021 TH 1 ~':; I'll II I" I I !hl il " /' 'i I I/.' 11, ,:Form, ... 1;1----;;;;:, 'tA" 0"""" "J'~l I ;Dlstrlct -Ti';!-r~,:i : F'I.lld.Jl.'lldll'l L._ , AI provided by seellons 6321, 6322, ond 6 ~ude, we ore giving 0 notice that loxes (lnel hive been assessed ogalnst the lollowlng-no I demand lor payment of Ihls liability, but I , there Is a lien In 'avor 01 the United Stoles property belonging 10 this taxpayer for the Iddlllonal penalties, Interest, and costs thatrT Nama at Taxpayer ,1,\,'11 '" I,)' ,iilhlJ ',I 'ii', 1'1 i,I',II:, 1.11:,1"111111, IMPORTANT RELEASE INFOrlMATION I'or ""ell ,1'",,,,,,,,1111111 11C1,)(j 11>'low, unless notice 01 lian if) rt~till!d by !l'lll (jilIn ~JIVIH11111:()'lj()111 (I~,I, nIl!; rlnllCf~l :;11;111 on the day tollowillg such di.llo, OpC:riltU iC.) il LI!rllIIClI\{! u! 1t!ll;il:W ;\',; tJt.dlnf..:d In IRi~2ilQ :il'<'I, , 1', 1,11./ I, 11',1;',1 I.', II ,1.1 ,.,,' . . , Tax Period Dato of Ended Identifying Number Assessment (b) (el (,I) Residence Kind 01 Tax (a) ':'4J "',11 ';'4 J "i41 '~41 "'41 '-14J. '),1.1 ';'41 ','141 ')41 ')4 I '''41 ','41 ').1.1 , I IPlaee of Filing j (.II.. I J j rl t.1 I J 1': I I... ,"'; I I, '," 11'11 f, II Ml:-t.llf.!'j 1 ( .;[:t.W,'t1 , r'/l, 1 /", ,', I I :; .,1 .I I "f I.lt-,.. ;()/I', " I I)' : / ~(l'" ,'" , I " I r' 1. i ~.:.' 'J 1 ... 1--;- (),;,I ,j I ,.' : ','(j 1 i"", ":tJ / :::t.l lYI/ :('/;:::(.1 1 ~,. " ."1 " :~:l) t ) .; " -~' 1 .. :'.-,: 1 t-,/;;, / ~;(} / :.:: t ()'",/ ,~,t') I ::',: l 1 / ,~:;I ;';;..; t (I,:,: I J I " U~: l)(-,,' ":1) I :::.:,:.~ (J'~I;. ,~(l / ::."i.. "', ,- 1 J, r'".1 ( ~ ~ j, " 7;" j,-, ~._ n'... " ~, .. .r l, t,:: I., r, i" "',' ii" ), /"::1,, ; ,; I ~,. 1 ' '; .. .. ", ~.. '..' , " , '~ . 1'.;(\/ '!l ,111'1', 'I' (I t h',.I'I!' t. d,t(' , 1111'1 bPI' I ~'111 Ii ., I' ,it" I I ,- I (" " ',\ nata: I t 1- ~ 't . , 'This notice was prepared and signed at the ,~';t d dayoflJ1y <) 'l- ,19__, ('L ~r-'-J:t ,',' "/,';:: ','I: 'I, ", :/ t. '--,'<; :/ ,'-.,. .' :. ;:.: !';:,::,' '.." ",' .,.'......"', ";:)/,' :':.:/,,-:. "I". ;';::; I': , " ,". ,,~..' 'I:j,: "! ',-:'-'-, ","C':'" ".:::: ";.:,i ':..',-:; 111'11. ','I 1'1 t ''I ,h.1 I f-! h 1 ,~_, (, I~ . ..-....-r-'II" " CA\'", /, ~,..,..... 'A."""--.-., (NOTE'l"(' ~, ',rt" 'I" 'I I Fitl'l f h,1 ,-', ,I',j "': '!' I' .1,' ._~ ' Signature .. ) ., f t.-L l"{ /-\. ,,1 rill by Rt/l."(JrdInO OUice- IO~ I FTL ~q(U\,1 d, I' 'IY J()'/ () II \ 'J:J'I'" Lost Doy for Raffling (u) Unpaid Balenee of Assellment (I) ,,', ,-,,-. ',. ::>~.,~., . 1,l ,. 4', , ",:..:::T. " . .,;':::1,'-:.....," .. (:::: I. ,,),' !;j 1. ~ 1 .lJ(J !S(l.,~~ (' . :-;':: ,'1,':/'":4. I.s:~; ,'p::;.'~ 1 . F;l) 1. ;::0 l. 4. :'~;r-, 11 r t'.~I. ..-::'9 J. 1F.i43. f),:,~1 I J ;;(i::;. 1 ::,~ I i'l;;:: 1 (~\" 0 l -"J '" I) , " / .".,' 1_;'" ,..,"/ ," \..l",,:, h_ ;.:... ':;:,',: ( )'.:.' ':'.: I '~:':",: t..",,.',; :,:/"_':':': C.' ,,';' ,;:: '.' ",:.' ,')':;,.. ,--; " '~;.:-:; ,., n l)' .-.,::.:,":i::,j ,;.; / '"~I;:,,: '/ '::':::': " ',/ ;". ~tl~:, . F', .; I.' ,..", ".' ,} _,:;':: L "(". Total ~ I.JI~~-'''::t l . . I:'~ $ " ~J_.-, ,') ,,) I) oJ ,] ,) ) .) , , t I , , on this, "'1 :1 I ~ (', I ',,'I' I ,(, -- .... --"..,.~--_.__. :Ir ", 1t!:II, !11 [1,,(,,> 'it 1,.dlHdl T.l_ 11011 Pdrt I ' \<('pt L.l1, !iC(;'irdillq Offl(~l\ / ,'''" 668 (V) (l'loiv 10a3) '.~ "HI::) 1\11111' I ',llhHl' I , 111.1 +, 1\'11, Ilil , , IForm 668 (V) .. .' ,) OoPUttl11l'Ilt of tlw r,ollsury . Illtonlul Rovunuo Servlco Notice of Federal Tax Lien ],30(1,]1 N~~'~~~'~ - -. -.---.-----~ "I II, ..----~--- -----. -.- .-.- - AI provided by sections 6321, 6322, and 6323 of tile Inlo",ol Revenue Code, we ere giving 0 notice Ihot loxes (Includlll\J Inlelu;;t lInd penllllles) havI been aSEessed agolnsllhe lollowlng-noll1ed taxpoyer, We hove mode . demand lor poymenl 01 this liability, but It rell1l1lns unpllld. Therelore, I there Is a lien In lovor of the United Stolos on 1I11 property and rlghls \0 property belonging to this toxpoyer lor Iho OIlWIIIlI 01 Ihese loxes, and Iddlllonal penalties, Interest, and costs thot may lICCllle, _.'_hh"_" ,.-____...__._ Namu of Taxpayer ,"\1'11", I I, I' I~ 1\1011 1,1 Mil ',I' 1,:1 ""'I I'll:', I "II !i. I ",.j I" I ]IAIV O~IQblll 1tl',I.J,' I ,District I , r'I'1 l,l,II.'II,III,1 Residence ! 1:: II.I( IJ:"; I 1"1111'11 Idl Ivlf:J t 1/11'll f '~ll lI,'II, r'/\ I,".' .1" -. I .1( l)plldll,fIIJSII hy fftJcordln(} Offletl :ttqt..l_ I-/Odl IMPORTANT RELEASE INFOHMA T10~1 1'01 '),ldl ar;:,'" :"""111 1"'I,'d [)"IOW, unless notice of lien is rofllmj by tho di1tn GIVI'fl III (:(1IIJI1111 il'), tlll~; IHlllCl) ~',11i\11, on the day following such dafn, opnralo a~; il O;!lltICltl} IJ111;:I';I:il! il:; (j.;jlnl?d in IRio6i2 9 :mE,:t, r'. III, J', 111(<1 III, I ,1',1 ". " ,.. IJtj,lU\.1 ('\- I" '1'l)U'/ Kind 01 Tax (a) Tax Period Ended (b) Identifying Number (e) "",'II ",'41 ,,'I'll ""41 "/,11 ""41. "141 ':'41 S.141 ""41. '::',11 ).11 ""41 '041 ':'.11 ,',;/ ..II'?'.) .I , . I. I , I , ,... 1 , I ,', , .". , 1 , I'),.,,' ,:(,/1',/ l)"/ / ')(\ II ! ,::,1 ~~ 1. / ,'.) (),)/~:; 1,1 ::~'!') ()(, /'.-;U / ;:.:i(l "I';) / :':;0 / :~Jf) 1..~/':I/O(.1 (l.; /~:: 1 / ::~: 1 II(J / ,~J(1! ::':: 1. ()':' / :"1") / I:) 1 1': I:::: J I' :;,~ I .,' ,:o.'? - 1./" ,_. .~, 1,',,1.' . (,',' \.', .,,', ......' " c....', ..:,:::' '::: 1.'..1.. ~::::'.. ":,,,/,:: [, ,::':-", ,:, r c: I,' ,,:,' ",',:,''/':':1.,' ,:' .:: .,J,J,,' I..,' ~ ::i' ... ;..1 ,:~ [I ., :~:.: I "C 1 ' () ;,i/ ..:: I 1;]2 1)(, / ';::/)! :~J,,~ () '~i / ,)('1 / ;:..L~, Place of Filing 'I' (, tI', ,,'," t., (ulnbfJl' !;,(Id ~.."lJt'11 ':: d.t. I j "', ! I; I f' ','\ 1, 1::,1 I" I J I fI d I ri t~': "I .1 1 n'~ n a t. d. : I,I.-J, .1 Oate 01 Assessment ((II ./;::: , " '.'. ',' / : ,."." ,: '.',", ."",.J (J, t\ J)J 1 'l) Last Oay for Reflllng (0) I) ./:: I,' '/". " fl'.," '., Ir',,' " "',J (j';' " .. '1:::: (:)' i'" ,,: :.., ":../ () :,:;..;';'"; 1:1';':'.. ' ,,' '''):;: I.......' .I n'>" .;"'.." ,'1..: " / ' ) ':-,' " .-~. '~I , .;,~. I , , , , ,:'.:/ " ,_,.n." , !: :~: ... ': I " ::.": ':': I ':~::/,::>'l ;,~,::':; ";':J,' ",it-::;:.; f J:':_;/ ; ':'''' :,:.::;".': ,:'.': / 'i-~ ',J / :~'::: ': :.' ,.:~, .':) .~ ..-,1.-"'..', '. " '.. "' ,~) 1)<;',/ 'c. :::,:/ ",.,::; o. :; / :i:.J I) ,./' '. <,'.,'., ",:' lY.i,'.., 'I "'...., FTL Unpaid Ballnce 01 Assessment (f) ,; . : ::: I:.' .~_. -,.'/ 'i,.::;-::"?'. :::.,./ ,.::;12.,..,1:, ,:: T':: r ," I I,:; l.~ 1 . ()I) !'~; f) ;,~~ /' " ::.:; ':.: ..~ ';/ 1'1, ~J ''l-:~.:..t 1 . 150 t >~l) 14 . ::)6 1 l r't'~). .::9 J. J.~) 4,.~ . (;, ',~' 1.1. ;J(n~ ~ l.:~ 1 (),;:: 11~1 ~ (ll '.' r'j!"'; I,." ,:, ..::,:: J. . (j,,,,, Total 11),/::1:.1 . "j:,~: $ This notice was pro pared and signed at i' j' I I 1 ,jl'.! I l-' h 1'1 ~ I"" I~ .. the :" oj day or" I. Y " '~ "i9~ Signature /"-~ lNOTE: I.'" d;'",~'" f1 f' V H, : I " ~ .\ , I ( ,~ L'}~...~__" ",.",:~,.,.\,::',.jl.i.'.li1" "-,.,,,., I 1 'I,' i ,j 1 H ,,'''. r~--~~ ':.1,1: , on this, Pdrt 1 . ~(l'pt fly HI.'ctHdinq Offic(\ "" . .1",1,1/ Lil rL..II< " ,)1 F Ildl)I'.11 r.l~ 1".11 I,,,,,, 668 (V) IF\"v 10,93) " .. (''', () 11 .J l J ,1 t il j 'rl ~ ii t ., lL l