HomeMy WebLinkAbout95-01472
Form 668 (Y) H.,r; Depertment 01 the Treasury. Internel Revenue Service
(Rev. Oclober 19931 Notice of Federal Tax Lien
District Serial Number For Optional Uss by Rscordlng Ollics
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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 been aaseased egalnst the following-named taxpayer. We have made ,.
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a demand for payment of this liability, but It remains unpaid. Therafore, r-J
there Is a lien In favor of the United States on all property and rlghta to ,.....
property belonging to this taxpsyer for the amount of thesa taxes, and -
additional penalties, Interest, and costs that may accrue. J =
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Name of Taxpayer -' " ""
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Residence U'1
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~q ,DO 0=1
unless notice of lien Is refiled by the date given in column (e), this notice shall, Cu.tl 7'1S'I1
on the day following such date, operate as a certificate of release as defined
In IRC 6325 al. ,l..ll ;)3Sn
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Tax Period Data of Last Day for Unpaid Balanca
Kind of Tax Ended Identifying Number Assessment Reflllng of Asseasment
(a) (b) Ie) (d) (e) (f)
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9.11 09/30/93 Z'l-IG76J09 t.:l // 11 /94 0::1/10/04 1'3410.12
941 12/31/93 23....1 C, 76 :;()'3 l.'i'/11/94 OH/IO/04 15982.29
941 03/.31/94 2~1-.1676'30-:l "7/11/94 (/;3/1<)/04 8935.07
i 9<11 06/30/94 23.. 1 G 76309 10/24/94 11/23/04 12050.93
, 941 09/.30/94 2J-187630~1 12/26/94 01/25/05 18516.64
i 940 12131/93 2"IG76309 10/17/94 11/16/04 1 152.12
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jPlace of Filing
i Total $
P,.othonotary
, Cumb~rland C ,_.un tv 76047.17
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This notice was prepared and signed at
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. on this,
the
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Signature
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::.,.f'l n 1.101:
(NOTE: Cortificate of ollicor authorized by law 10 take acknowlodgmonls 15 nol fJssontlallo the validity of Nolicu 01 Foderal Tax lien
Rov. Rul 71.466. 1971 .2 c.e. 409)
Part 1 - Kept By Recording Office
Form 668 (Y) (Rev. 10.93)
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Form 668 (Z) " Department 01 the Treasury. Internal Revenue Service
(R.v. ~.O') Certificate of Release of Federal Tax Lien
District Serial Number Far Uss by R'Cordlng Ollie.
.'r, , : .j d,,' i pli , , '--'I ,. ,
I certify thll la 10 thllollowlng.name tlXpaYlr, the requlrementl ot lectlon 6325 (a)
olthl Intlrnal Rlvenue Code hiVe beon IltlllIed lor the tlXOIlllted below end lor
alf atatutory Iddltlonl. Thlrelore, the IIln provided by Code lectlon 8321 lor thele
texes end addltlonl hie been releeald. Thl proper olflcer In the,olllce where the " ""'"
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notice 01 Internal revenue tlX lien wea lIIed on t! 11 '_!: .....
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Is In luthorlzed to note the book a to Ihow the release of this lien lor -
thoae taxos and additions - ..
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Nomo of Toxpayer ~ .: W
'. DAVID ";:j'F ;\LPi":-':,: ':. C~ ~. ~
lIi\ J F:'{ ';11.11. Cl'.l Dr,:l 'IT lrl ;.\:. ;..,
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Residence 1 ~ '.' f LIJ\IE h'U Ii! ~-i;, r.: ~.\ , r~ r,'f\.I~' ....1 .., -
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6.111 'r:'L::.I'~:~:l:"Ur~I,_1 ~ i','\ : ~'. ,
IIUF.;T RECOJ'<D!t'J(; ) NF':'F'~lA T ,...N; 1lS.ropd
, i bet'" F'''3E' LIce [.1.;,. -.( ] , "i I !'!""" tM....1?"J~'I:1.
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r" ~ n/d n. " """', 1 ~r; ::. i t I '" u ;).9;)",","
Tex Period Oateol Last Day lor UnpaId Balance
Kind 01 Tax Ended Idenllfylng Number Assessment Reflllng of Assessment
(0) (b) (c) (d) (0) (f)
',',11 (/71/ ::::(1/ C'1''j -. ,:i\' j ,~- ' 1 (I' " ~ ~ I
,-_.:::--,:/" it;. "1/ 1 ! ./ '-., ~+ 1):.:-: 1':'4 10. 12
"'.11 12. /:31/'7}:.:: ;;<~: - 1,'~, 7 i<:':j".; (17 , I 1 / -:'4 '):,_: " to, ( ~. \ 1~,'~::',2.. ;~.,:;
':',c\1 (l~;/31 /94 ~::;.: '-1"_,7':,,;':(1'-'- , ... 1 1 /<,,';- '.l:?/li_'J,'('iAl ::::'~/3ei . 07
'-'41 (16/:30/94 23-1.::.;" -..::(l':' i. t:~/ .:.>ll '':;J<1- I J 1<::::::/(14 1':~'()5f). ';t:-..:
';''''~ 1 (1'-;) / 30 I ';' 4 2.:~:"; - l~, ,i 1,:, .>", ',;; I '. / .::. .:..":J ~l ':') /':15/(j~:, 1 :;:::516 . 6~1
"'40 L~/ 31 /';J':-: :::;.~ -.I ,.:.7 ,:,':~:(J'~/ 1 '.1/1 '7/':)4 1 J .. j ,~,:1)4 t 1~"':- I"
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Ploce 01 Filing
F', I,' th('I", t itl ..' Total $
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This nolicb was prepared and signed at
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. on this,
the ~ r! day of--! u I
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Cvf",,~,.~tJ al O/fiCI" ./Vtltotrlt'(1 by "o1~l~e .1c....no~lf'dQmt'flIs IS I'Clt'HU":"'! r~' '''to "'_"'':'~l' ~'f C8rM;CJto 0' 11~llJase of rederal fa. f,en RBV, Rul, 1r.466, 191r.2
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~..t-V~ . , PART 1 . nECORCItlO OFFiCe FOfmeea(Z)(Rev,~9")
CAT. NO 1lOO281