HomeMy WebLinkAbout94-05012
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'orm 668 (V)
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Notice of Federal Tax Lien
Olslrlcl
SHrllI1 NlIlnl)11l
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AI provided by secllons 6321, 6322, and 63n of 11\0 Inlornul Revenuo
Code. we oro giving 0 nollco IhallaKes (Includlll!J Inlo,.,',1 I1nd ponnlllos)
hive been o59ossod egalnsllho tollowlng-nol1led loxpuym, Wo hnvo modo
a dlmlnd for payment of this lIablllly, but It ,el1101115 ,uIJlnlrJ, lheroloro,
there Is e lien In favor 01 the Unltod Stole5 011 nil fl'OflDIlY and rlghls 10
property belonging 10 this taxpayer lor Ih" 0I110lnl1 01 these IUXO!l, and
addlllonal pellellles, Inlerest, and costs Ihnt n,oy ,u:cruo,
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Name 01 Taxpayer
1\'11-1 'Y(JIJ f1L
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Residence
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Kind of Tax
(a)
Idontlfylng Number
Ie)
Dale of
Assessn",nl
(.11
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~ ~tJ./)t) jY/'I''//
t'/J fP :?n..J7
,j$ I 'iuV,';
Last Day for Unpeld Balance
Roflllng of Anusmlnl
'0 (~
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IMPORTANT RELEASE INFORMATION For o<lell <1""0';""1<'"1 1151,)(\ IlOlow,
unless notlco 01 lIon is rnlllod by 111<' d,ll., ')'VOI1 In ('1'11111<1 (ll), II",; 1101lC'j ,;11<111,
on the day followIng GUcll dtlto, oporllln .I:; ;1 I;lnllllcillll of Il]lc),l:')O ;l~,j dulillod
In IRC 6325(0 ,
Tu Period
Ended
(b)
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Place 01 Filing
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This notice wns prepared and signed at
, on Ihls,
"<I
the
day of _,
19_.
Signature
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rNOTE . ;.t" .,'r. ,f ,,1", I .1',' ~I:" .,~ I.;
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Part 1 . Kept fJ'I fkr.ordillq OffiCI)
form 660 (V) (R,JV 1093)
Form 668 (Z)
I~" ~'V41
OepI,tmlnt ollhe T,e..ury . Inlernll "evlnue Service
Certificate of Releall of Federal TI. Lien
~II,~'IC:I re,111 Numb.,
I certify Ihet II 10 Ihe lollowlng.neme Iuplyer. Ihe ,equlramlnll of leellon 1325 (e)
ollhe Inlernll Revenue Code heve been sllIslIed 'or Ihl luel 1I1lld below Ind for
III Ilelulory eddlllon., Therelore, the IIln provided by Cadi leellon 8321 lor Ih...
'eKel end eddlllons hll been ,eleesed, The p,ope, olllc., In Ihe olllee whe,e the
nollce 01 Inlernel ,evenue leK lien wss lIIed on,
19 . , Is In outhorlzed 10 note the books 10 show the ,eleDs. 0' Ihll lien 10'
IhDS. teKDS ond oddlllon8
'or U.e by Ilno,dlng Olll.e
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Kind 01 To.
(u)
TOK Po,lod
Ended
(b)
Idenll!ylng Number
(e)
Dolo 01
AssDSsmenl
(d)
Losl Doy 'or
Retlllng
(e)
Unpold Selonee
01 Assessment
(I)
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!o ~ ~ ,', , '. 1.
Ploce 01 FIling
i'
Tolel
s
rhl~; rlOllCll WiI:> prtJpnwd and slgntld at
, on this,
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StflllUlllrt!
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Ir'~1 J i! \, 'I', .,;., 0,1 ,'II,'" ,lLlrtle'p:!',' Ily 1,/\\' II! 1.111/.' ".-1111",",11'111/111, "~I I'.' !lot "",'II/',ll/ll rl',' '1./11111/1' of Cerli!Ic.HII 01 (1,/IHi'51! of Fedflfil/ r,h /!I!n FI~v flul ".466, IgJI,,?
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PART I . RECORDING OHICE
Form '''IZII~'v 1l-1lo4)
CAT, NO eoo281