HomeMy WebLinkAbout94-05029
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Form 668 (Z) JUU Olparlm.nt ollh. Tre..ury . Inlernll R.v.nu. SlIvlc.
(AOY, &~4) Certificate of Release of Federal Tax Lien
Dllfrlcl SIIIII Numb.r For UI. bv Rocordlno Ollie.
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I e.rtlfy Ih.111 10 th.'ollowlng.nlm.laxp.y.r, Ih. rlqulr.m.nts of s.cllon 6325 (I)
ollh. Int.rnll R.v.nu. Cod. hlv. bl.n ..lIll1ld lor the lu.. IIsled b.low .nd for
III 1IIIutory .ddlllons, Th.r.for., Ih. lI.n provld.d by Cod. s.cllon 6321 for Ih...
tlUI Ind Iddlllonl hll b..n r.I....d, The proplr olllcor In the olllc. where th. <..
nolle. of Inl.rn.1 r.VlnUIIIK IIln wIslll.d on .;,'.' I' I, ",,,Io::,~:,,::,,_ $
18 ~ Is In .uthorlzed 10 not. the books 10 show Ihe roleolG of this lien for "-
Ih... tu.. Ind .ddlllonl I.J;.)
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'lex Period Dote of Last Doy for Unpaid Bolone.
Kind 01 Tex Ended Identifying Number Asseesment Reflllng 0' Aeeessmenl
(8) (b) (e) (d) (e) (f)
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941 I)':) / J(l / ,}( ~~: 15 ' 1/,:-,. .1:,:4/" 1. Ii'::: I' ,'. I. ,I .:~, ':,: / Ii" .~;"):D~~ . I)!:",
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Plec. of FIling
1=',," nth (I II (I ~ i1 t.- v Total $
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This nOlicr, was prepared and SIGned at
j 'II I I ,~ ,i I" 1111, I ,i, 1 F' ^
, on this,
the:<t c t day 0121.'\1
,19~,
Sign~/""
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PAHT 1 . HECOROING OrFIC!
Fo,m I" (I) (Aev, &-84)
CAT, NO 1lOO281
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Form 668 (V)
tA.'V OClob1l1 I\HI.] J
Dopo,t","nl 0111111 Trell/lU'y .Inle,nlll Revenue Service
Notice of Federal Tax Lien
,Dlstrlcl
StHlill NlJII1IJIU
I ,Jf or/!I)!!'" /1:10 ny fllJcoruln{1 OffIC8
As provided by sections 6321, 6322, und 6n:1 01 1110 Inl'!tf1nl l1evonuo
Code, we are giving 0 notice that tOKe5 (lncludlllg IlIlo,o,;t nlld pennltles)
have been assessed against the followlng,nnmed tuxfluyer. WI] l1uve mode
a demand for poymenl of Ihls lIublllly, bul II 11]11101115 IJl1pnld, Therefore,
there Is a lien In levor 01 the United Sloles 011 011 flroJlolty and rights 10
property belonging 10 this laKpayer tor Ihe amollllt of 1I1ese taxes, and
addlllonal penaflles,lnlerest, and couts tholmuy OCClue,
,Name of Taxpayer
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, Residence
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IMPORTANT RELEASE INFORMATION For oncl1 ,\r,';1,:;';/111)111 '''31,!0 bulow,
unless notice of lien is rolllod by tl10 daln OiVIJIllil C0111l11111u) 1111'; nollco sl101l1,
on Ihe day following sucl1 dnle. opernlo il5 n CI.'IIIII(;OIIo! 01 IUI"OI:;" '\'3 dollllOd
in IRC 6325 a ,
Tex Period
Ended
(b)
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':j. tj, ~71.
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Unpaid Balance
of Asaessment
(f)
Kind of Tax
(a)
Dllte of
A5scs~mcnt
(<Ii
Lost Day tor
Reflllng
Ie)
Idenllfylng NL.l11ber
Ie)
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Place of Filing
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Tolal $
This notico was prepa'lJd and sigrhld al
, on this,
the
day of __
18
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Pi.trl 1 - I<cpl Uy f1ccrm1iIl'1 Offic"
Form 660 (V) (Flev 10-93)
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