HomeMy WebLinkAbout94-05651
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Coparlment 01 tho Tre.,ury . Inlornal Reyonue Servlco
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!Form 668 (V)
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IOlstrict
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I property belonging to this texpeyer for the amount 01 these
j additional p.snaltles, Interest, and costs that may accrue.
jName of Taxpayer ,'\'
!Rasldence
Notice of Federal Tax Lien
Serial Number
For OptlOnill U'd by Rtlcordlnq OUlc.
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue
Code, we are givIng a notice that taxes (Including Interest and penalties)
have bean assessed against the following-named taxpayer. We have made
a demand for payment of this lIablllly, but It remains unpaid. Therefore,
there Is e lien In favor 01 the Unlled States on all property and rights to
taxes, and
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of lien Is refiled by the date given in column (e), this nollce shall, '1lq ,00 rd
on the day following such date, operale as a certificate of release as defined C.k t:t 007S39;J....,
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Tax Period Date 01 Last Day for Unpaid Bal.nc.
Ended IdentifyIng Number Assessment Rellllng 01 A.....m.nt
(b) (c) (d) (e) (I)
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Kind of Tax
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Total
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This nolice was prepared and signed at
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day 01 c.,
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Signature
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',,:.I,,':111h';:!', I, e;l ",..d'1'_11 tJ ttw \/,jlidlty 01 NQtlclJ 01 Foderal r.).'1 linn
Form 668 (V) (Rev, 10.93)
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Part 1 ' Kept By Recording Office
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Form 668 (2)'
(RIY, IHoI)
Olatrlct
Department 01 Ihe Trsasury - Intarnsl Aavsnu. S.rvlc.
Certificate of Release of Federal Tax Lien
Ssrlal Number
for U.e by ReOordln 01110.
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I c.rtlfy that.. to th. lollowlng-n.me Illxpaysr, th. raqulremsnt. 01 aactlon 8325 (.)
of tha Intarn.1 Aevenue Code h.v. !Men utl.,1ed lor the t.... II.t.d below and lor
.11 .t.tutory .ddltlon.. Th....fore, the IIsn provided by Cod. uctlon 4321 lor the..
taxes .nd .ddltlon. h.. !Men rsl....d. The propar officer In th. offlc. whet. th.
notlc. ollnt.mal rev.nue ta~: IIsn waf fII.d on' I, t, ' , i , " '
.j 19 ---J I. In .uthorlz.d to not. the book. 10 show the raloa.. of Ihl. lien lor
thase laxas and addlllon.
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Lnt Day for Unpaid Balanca
Aaflllng of A.....mant
(e) (f)
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Kind 01 Ta.
(s)
Tax Period
Endad
(b)
Date 01
Assessment
(d)
Idenlllylng Number
(c)
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Place 0' FIling
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This notic. was prepared and signed at:. '
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Title
t~~. .lfldJ':<J~OI ort,e'f( .Jul"fJltld J:' I.., It; 7.J(llno..lttt;f'.JmtIflIS 13 nol es.s~nfl.:tl ro me y.JllcJlfy 01 CtHt/!II.:.:tI" 01 RtllfI.J$1I of FIKNraJ Ta. ;,.n R..." Rut 7'-466, 191/-2
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I .;;::: -.. PART 1 . RECOROING OFI-=ICE Form Me (Z) (A.... &-i041
_ CAT. NO IOO2Il
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