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Form 1I66(Z) oepurlmenl 01 the Treeaury . Intern.1 RevenuI Servlee
(Rtv ~.71 Certificate of Release of Federal Tax Lien
1Jlllrlel 8erlel Number For Uee bv Recordlna Offle.
!" '''' " ',-,ill
I cerllly thallhe followlng.nemed teKpayer, under the requirement. of aecllon 8325 (e)
of the Inlernel Revenue Code he. eallafled the lexea lIaled below end ell Italulory
.ddltlona, Th.r.fure, Ihe lien provided by Code aecllon 1321 for Iheae lex.. end
.ddlllonl hu been releeaed, Th. proper ollleer In Ihe ol1lce where Ihe nollee of
Intarnel revenue lex lien WII med on -. --~ -,-+ .'m._.. --- ,
., , " Is eulhorlzed to nole Ihe books 10 ahow th. relees. of Ihls lien for
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th... teKea end eddlllon.,
Neme 01 Taxpay.r " ,
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Rllldence ,
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Kind of TSK Tex Period Ended Identifying Number oete of Leet Dey for Unpeld Belence of
(a) (b) (c) Aesellsm.nt Reflllng Aa....m.nt
(d) (fI) (f)
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.,,\ 1'1 fI'8 PC"-tJ ll.lll.\. \,,,,.\\) ~\c~\'" l......\
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Pleee 01 Filing
, j'lj; " " Totel $
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This notice was prepared and signed at ._m_ L_c__l.-..- ~~_L ___ _ _ _ _ __ n_____...________._______ , on this,
the __":"_c..l.. day of. _ :.~'_',_:.._. __ , _~..J~'
Signature
_I Titlo
INOTE CI.'lllrl(.II,' u! (j'fictH d/)Ih,)fl/~"j t,w 1m... I,l 1.111" i!l'!.I1';W!l'd!11f1111l15 IS /1l)r p.sSIlI1/1iI1 I() IhH V/JI;OI/'y of CertilwlJlf1 of nOltl,I:>1J '-" Fl}deml J;u lien Rev, Alii 71-466,
01 ;,
1971.2 G.a, 409)
PART 1 . RECORDING QFf'ICI!
Form eee (Z) (Rev. 8-97)
CAT NO 600261
~
1 Form 66B (V)
LAllY OI,:IGI)lI' ''J'Jjj
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AI provided by sectlllns 6321, 6322, IInd fin3 ", lite IntlJrnlll f1l!vunue
Code, we ere giving e notice Ihol taKes (Includln() Inll!/IJ';I IInd ponolll(15)
, hive been essessed egalnsl the 101l0wlng-nul11lJd tllxpoY<1r. We hove Illodc
I demend lor paymenl 01 this liability, bul II IcnHlIiI~ 1I11pnld, Therelorc,
Ih.re Is e lien In lavor of Ihe Unltod Stales on 1111 propr!lly IInd rights 10
, property belonging to Ihls tDKpaycr for tho ol11ollnl of Ihase toxas, Dnd
Iddltlonal penalties, Intercst, and cost~ thllll11UY IICerlll!,
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'Name of Taxpayor
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Dcplltlmonl III Iho TIOll,;lltY , 1111"111111 Ilovonuo Sorvlco
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Notice of Federal Tax Lien
1-,', r),~tllJ/ldl UlifJ IJY I1f.lCCfdlllg Onle,
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Kind of Tax
(a)
Identifying Numbor
(e)
Duta 01
Assessment
(,I)
Lust Day for
Reflllng
(0)
<.i. It '/("ti!, ~I
('/) ,~' ;..:U..;J 7
",)I'po.- I'
F JlH'"/
Unpaid Bellnc.
of A8IUlmlnl
(/)
CI
IMPORTANT RELEASE INFORMATION For <lad1 .1"".],;:;l1llJlIllI';I,'d lJolow,
unless notice 01 lion Is rolllod by tho daln giVOl1ln collllnll It'), 0",; /)(111<;" "1Iall,
on the day following such datu. oporato [IS tl CllftillCillU o! 't!lt~;l:~I; t,l') dullnud
In IRC 6325 a ,
Tax Period
Ended
(b)
()
o
c
.
.
.
the
day of
19_
.
,. .
.
Tolal $ .
.
, on this,
.
.
Place of Filing
This notice was prepared and signed at
Signature :'v' c"IL}j.' ~~~-,"" ~~~TIIIIU__m..
(NOTE: 1:"1',' "11"', t .101", '_.n flfr" j14il.:t..,I,':<' I, I,""'.it '.' "", ,t, "I,;" II, ',',lllrJ,ly 1)1 f'jt}I;(~I) uf FIJdlHill LD, 11.,n
HI'" 111;1 ;, .Ii", \'],'1 :' I; [l ,ll\'!1
Port 1 . Krpl fly Flee nrdi Il'! Office FOrtll 668 (V) (F\lN 10 Q3)
.