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~orm 668 (V) I " Depsrlmenl 01 the TreBlury . Inlernel Revenue Service
IV. Ocloblf t09Jl Notice of Federal Tax Lien
Islllcl Sorial Numbor For Opl,tHIaI Use by Recordmg Ollies
, II" I "''-' "" ,,' 1/\ ' ,,',I,
AI provided by lecllonl 6321, 6322, Bnd 6323 of Ihe Internal Revenue \\q~) :ya \C,
Code, we Bre giving B nollce Ihel laMes (Including Interest and penallles)
hlVI bien e..Blled egalnlllha lollowlng,named laapayer. We have made
I dlmlnd for paymenl 01 Ihll liability, but It remalnl unpaid. Therefore,
Ihere II a IIln In lavor 01 Ihe United Slates on alt properly snd rlghla 10
property belonging 10 Ihll laapeyer for the amounl of IhelO lauI, Bnd
IddlUonll plnllll...lnlerell. and COils Ihal may accrue.
,Name of Taxpayer IAI'IL:, 1'1 lrl{ (hM "
Residence ,,',-. H r.IJIIII'1 L1!
, r tJI.t1 (\ , 1'/\ J /11, . ,.- '1'1' ',/\
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IMPORTANT RELEASE INFORMATION: For each assessmentlisled below,
, unlsss notice 01 lien Is reWed by lhe date given In column (e). lhls nollce shall,
, on the day following such date. operate as a certificate 01 release as delined ~\I L\.lid
In IRC 63251a\, l \\U I-;L','ju.:l RJI J.ri'il",1
TI. Period Dale 01 Lall DIY for Unplld Slllnc.
Kind of T.. End.d Idenlllv1ng Number Annlment Rlllllng of A.....m.nl
'(a) (b) (c) (d) (8) (II
1114(1 I; i ! I " "I . Ii, .., '.4::',1 , " 111.1 . . U,I.I.l
Place at Filing
1! "I 11,1,. t '11, Total $
, lJlid I I 1 111.1 Il,t, I ,1,1
. ..' t 1 I,. i " I
This nollco was preparod and slgnod 01
, on Ihls,
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the I! I I, day 01 "l'"
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Slgnaluro T'JW
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(NOTE: CfHll11(ill III ull'fl" aul!loILll'd 1J11"", III l.tl'l' , ",.,to" ,'reI', ", 1,,11" ;"'''1 .111') 1t,j. ",llo(llt~ III H()11t1l 01 IIHhllRI 1111 Iltlll
flu\! !tvl 114(il\ HJ11 ;'CIl 4091
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Patt 1 . KCJll [ly Rccordlng DlllcD
r011ll 668 (V) Illov 10 OJ)
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