HomeMy WebLinkAbout94-05008
Form 668 (Y)
DUfJurlnwll1 ,,' 1110 T'ClI'llJrY - Inl",llul nuvunue Service
tRltv O,tobl]l l',.IlIJ)
Notice of Federal Tax Lien
District , . ., .. , r~!:r~;I:~;''-llill'';::~~:,:::~~:-~~~-~_
As provided by secllons 6321, 6322, and G32:l of Ihe Inlel'l1l1l Rl'vol1ue
Code, we orf! giving 0 nollce thot taxes (Incllldln(l Illtn",';1 Ulld pl!nllltles)
, hlv. been assessed against the followlng-Jlulllnd taxpayor, Wo hnvo modo
,
I . demend tor paymenl of this 1I0blllty, but It relllalns unpuld, nwreforo,
, th.re Is a lien In favor of Iho United Slot"s on all prCfwrty and rights to
, prop.rty belonging to this tOKpoyer for Ihe olllount of lhoso 10 xes, and
I .ddlllonal penultles, Il1ler051, and costs thotl1luy nccnw,
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,Name of Taxpayer ,
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IMPORTANT RELEASE: INFORMATION. FlJr ."lell ,liJ';':';':ll1t:IlIIi:;t,)(llwlow,
unless notice of lion is refllud ~JY 1I1U (jilIn OIVt~11 ill COllJllHl (HI, \111:, llOII(;l! :.-;11;111, ('I.' -fII- ;; ,r; ')'...;)7
on the day following sucll (jaIl), Orwratl! ~i~; i\ CI;tlilICillr: 01 rl:l(:;l~;t! :1", dllllllfld -"U ,~
In IRC 6325(ClI 'II r I ")(,u'-/
Tax Period Dal" of Lost Day for Unpaid Balance
Ended Identifying N\llllber Assessmellt Reflllng of Assessmenl
Ib) (e) (,II It!) II)
Kind of Tax
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'place of Filing
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Tolol $
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This notice was prepared Clntl slglltJd at
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, on this,
the
, day of
- ' I!) _______:
"fr..'.. _____-0_____
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, Signature
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iNOTE :"". ,:,,' ',I ,;,1 '.' ,'I r, ,,' ., ',t , , ,
11'."J HII ., ,:1 I, 1 'J; I ;' ( Ii .1,,":
." P.H! 1 - I\"pl ll'l Il,'urrdlnq Office
, !i,,, '<,1~"Jd'1,:d f'J'llIU! 01 rf!(HH.11 lill IIIff1
I' Grill 668 (Y) (Ruv 10-93)
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Form 111l8(Z)
(RIV.8'97)
Olltrlet
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Olplrlm.nt of th. Tr...ury - Int.rnll Rlvlnul S.rvle.
Certificate of Release of Federal Tax Lien
Slrl.1 Numblr
I e.rllly thatlhl followlng-nlm.d tlKpay.r, und.r Ih. r.qulr.m.nll of I.ctlon 8328 (I)
of th. Inl.rn.1 Rlvlnu. Cod. h.1 1.1l1f1.d th. lax.. 1I11.d b.low .nd .11 Itllulory
Iddlllonl. Th.r,for., th. IIln provld.d by Cod. I.ctlon 8321 for Ih... tax.. .nd
Iddltlonl h.1 b..n r.I....d, Th. proper oNlelr In th. oNlc. wh.re th. nollc. of
Inl.rnal r.v.nu.laK lI.n w.. fII.d on ___._m~____~_'_',C.':.n:'~d_._'nd______._m__.-'
.__~, II authorlz.d to nol. Ih. bookl to Ihow th. r.,.... of thla lI.n for
Ih... tax.. .nd Iddlllonl,
Nlm. of Taxp.Ylr
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For u.. b Aloordln ONle.
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Lut O.y for Unpaid Bal.ne. 01
R.flllng A.....m.nt
(.) (f)
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Kind olTu
(4)
TaK P.rlod End.d Id.nlllylng Numb.r
(b) (c)
O.t.of
A.....m.nt
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Plae. of Filing
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This notice was prepared and signed at
the ---'-.::-'_ day of
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Ii I,i
Tot.'
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, on this,
Signature I Title , ,
(NOTE' Cer/!lIL'tJI~ 0/ dflCtJr dlJlnorl/ed by Mw fa 1,)IIIJ (Ickllmt;/tUJI1IM8nIS IS nut 8588111'11110 the validity or Cor/llh;iJto ", fltllfftus of FrJcJsfIIl TS!lllfln Rev. Rul, 7'.0'68, '97r.2 C.S, 409)
PART 1 . RICORDtNQ OF"CI
Form eal (Z) (ROY. 8-87)
CAT. NO 100281