HomeMy WebLinkAbout94-05024
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, Form 668 (V)
tRev, O';lobu' 1I1'JJ)
f)upnrlrlH.HlI of !I'd TllJlltlury . Inter nul nnvor.uo Servlco
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Notice of Federal Tax Lien
District
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AI pro"lded by socllons 6321, 6322, and 632~1 0' Ihl! Il1lurnal n"venue
Code, we ero giving 0 nollco IhollaKes (Including IIIII!II!';I nml penalllos)
hl"l been ess8Ssed ogolnsltho followlng-namod InKpuycr, We huve made
a demand for payment of Ihls lIublllly, but It Imnull1s unpaid, TI1erelore,
thlre la a lien In 'ovor 0' Ihe Unltod Slales on all properly und rlghls to
property belonging to this tupoyor tor tho ul1lounl ot 1110~o lUKes, and
Iddlllonal penellles, Interosl, und costs Ihatl11ay accrue,
Name of Taxpayer
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Residence
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IMPORTANT RELEASE INFORMATION For oneil :1';:;":','"1',111 I,,;t,'d bIllow,
unless notice of lien IS relilea by thu dalp !]IVl!11 III C.,I,IIIIII I"). III,'; 11<)11(" ,;lli,lI,
on the day following such dnto, operaltJ il~; a {;I;ltdIC;llt)ul rl.~h!;!~;o il~l dullllUd
In IRC 6325(a ,
Tax Period
Ended
(b)
Identifying Number
10:)
Dule ot
Assessment
(eI)
Lust Day tor
Rellllng
(0)
/I)"'" ? 53:;;"7
~lt-t
,. It:J~/U
Unpaid Belance
of Assessmenl
(f)
1
). '1;'
I :1
I,
'I
,1
Kind 01 Tax
(a)
',I :'
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,I, 'j,
1101
Total $
f,..1
til
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Place of Filing
\il'"
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This notice was prepared and signed at
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, on this,
the
! 'day of
!,'I ',19~j.
Signature
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P,lrt 1 - Kcpt Dy nc!~nldi"'l Offi,~!'
1-orn16GB (V) IRev 10.93)
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Form 668 (Z) Oap.,lmenl 01 Ihe Treeeury . InlernlJ Revenue S.rvlee
tAl' &,g~1 Certificate of Release of Federal Tlx Lien
Dlllrlel Serial Number 'or UI. bv R.oordlna Ollie.
,
I e.rtllv Ih., ea 10 Ihe lollowlno,nem. laMpayer, the requlr.menl. 01 ~eetlon 6325 (al
01 Ihe Inlernal R.v.nu. Code h.v. been sellefled lor Ihe IlK.. IIlled below Ind for
all alslulory Iddlllone, Ther.lore, Ihe lien provided by Code section 6321 'or Ih...
l.uI snd eddltlone hue been relesaed, The proper ollie., In the ollie. where Ih. , , ,
,
nollee of Inlernsl revenue IlK lion woe tiled on , ,
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19 ..____ __, Is In aUlr,orlzed 10 note the books 10 show the release of Ihls lien lor .. "
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Ihose laxes and addlllons , J
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Name 01 TOKpaye, , '.l
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Residence i" ,.
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, c.,," 1'69;;>5,,\
- P. IS t:. -:1 >il,)(p
TAK Period Dale 01 Lasl Oav lor Unpaid Balance
Kind 01 Tux Ended Idenlllylng Number Assessmenl Retlllng 01 Assessment
(0) (b) (e) (d) (e) (/)
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Plaee 0' Filing
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Tala I $
rI,l:) nollr;o Wil5 pwpilrod and signed at __
, on this,
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r~~' J! I I '/'/' 'd., ,,, ,/', ,lIdll, 1/,,1'11/'I"oIW III I,I~'" ,!,~',:\~','d()II'!I'r', ", I'." t'~~,I'IIII,jl Il) /llt' ~d'I(111)' of (:"",111',11" 01 nHllj,I.~e of FedlUil1 r"" lien Rev flu/ "'''66. u}7r2
C;H ,II' /,
PART I . RECORDING OffiCE
Form,1I (Z) (Aev &,g4)
C~T. NO SOO~SI