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Form 668 (Y) Depertment 01 the Treasury - Inlernel Revenue Service
tRev. Oclober 1993) Notice of Federal Tax Lien
District Serial Number For Oplional Use by Recording Ollice
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As provided by secUons 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a noUee that taxes (Including Interest and penaltlas)
have been assessed against the following-named taxpayer, We have made ~
a demand for payment of this liability, but It remains unpaid. Therelore, "'
there Is a lien In fevor of the United Stales on all proparty and rights to ...
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property belonging to this texpayer for the amount of these taxas, and c:::>
addlUonal penallles, Interest, and costs that may accrue, is
Name of Taxpayer 1~1,\;:: 1 L i ~ 1,\; "
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IMPORTANT RELEASE INFORMATION: For each assessmenlllsled below, C..c '" l'i'l<ClO
unless notice of lien Is rellled by Ihe date given In column (e), this nollce shall,
on the day :(o~\OWlng such date, operate as a cartltlcate of release as defined ,ZlI ';).';l.lJ>TJ.
In IRC 6325 a .
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ended Identifying Number Assessment Rellllng of Assessment
(a) (b) (e) (d) (e) (f)
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This notice was prepared and signed at
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(NOTE: Cortillcnte 01 oltlcef authorized by law to take ackMwlodgmenls 15 nol ossenllal 10 tho validity of Notice 01 Federal To_ lJOn
Aov Au' 7"466,197' ,2 C,B 4091
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Part 1 - Kept By Recording Olllce
Form 668 (Y) (Rev, 10,93)
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Form 66S(Z)
(Aev8.971
Department 01 the Treaaury - Internal Revenua Service
Certificate of Release of Federal Tax Lien
Dlatrlct
Serlel Number
For Uae b Recordln Olllce
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I certify that the lollowlng-named taxpeyer, under the require mente 01 eectlon 6325 (a)
01 the Internal Revenue Code has satlslled the taxea lIated below and all statutory
additions. Therelore, the lien provided by Code section 6321 lor these taxea and
additions has been released. The proper olllcer 1rI, thll, 9lflce where the notice 01
Internal.,.~nue tax lien wae IlIed on
, Is authorized to note the books to show the release 01 this lien lor
theae taxea and addition a,
Name of Taxpayer hi.;F lLY!! 1'; ~:/)~,:r!r(';:.~..I;
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Laat Day for
Reflllng
(e)
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Unpaid Balance of
Allellment
(f)
Kind of Tax
(B)
Tax Period Ended Identifying Number
(b) (a)
Date of
Alselsment
(d)
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This notice was prepared and signed at
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the
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day 01
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(NOTE' CorMCdre 01 O"iC,IfaulhOrizfH1 by law'o ,akeacJcncwledgm.",.15 no'esS6",ial'o the validity 01 Cer!/ficato 01 Ro/oase 01 Federaf Ta.l,.,n ntIV Rul, 7'"",IJIJ, '97r.2 en "09)
Slgnaturo
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PART 1 . RECOROINQ OFFICE
Form HI (l) IROIf 8,971
CAT."o 6OO~61