HomeMy WebLinkAbout95-03206
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Form 668 (V)
(n.v OClobe, 1993)
Deportment of Iho Troosury . Intolllol novonuo Sorvleo
Notice of Federal Tax Lien
Dlstrlcl
SlHlal Numb!!r
hH OptlO/1al Usa by Hllcorc1mg OfflC9
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Aa provided by soctlons 6321, 6322, ond 6323 of Iho Inlornol Rovenue
Code, we are giving a nollco that taxes (Including Inlerest and penaltlos)
have been asseased agalnsl the lollowlng.narned taxpayer. Wo havo modo
e demend lor paymenl of this 1I0blllty. but II remolns unpaid, Theroforo,
there la a lion In favor of tho Unltod Slotos on oil properly and rlghls to
properly belonging to this taxpayer lor Iho amount of thoso toxos, ond
eddlllonal penallles, Inlorosl, and costs Ihat may occruo,
Name of Taxpayer
IMPORTANT RELEASE INFORMATION: For l'<lel, assessll1untltslnd below.
unless notice of lien is rehled by Ihe dalo glvon In colull1n Inj, Ihls noticn sllall,
on Ihe day lollowing such dale, operale as a curl,l,e<lln 01 ,elu<lsu as de lined
In IRC 6325 a .
Tax Period
Ended
(b)
.Resldence
Kind 01 Tax
(a)
Identllylng Number
(e)
, ,
Place of Filing
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This nolicn was prepared and signed at
the
day of,. ,
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Signature
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Dato of
Assessment
(d)
Last Day for
Reflllng
(0)
Total $
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JTill1l
(NOTE: LI!lI.f.(;IlI' 01 nil., 1'1 .11.lh;i!i/l',.l Il'p' II;',' 1<1 It"" ,I' .'L .'I'lq "1 ,,'.
nov Hul 71 "hli I'J/I ? f: 1\ 41''"11
Unpeld Belence
of A88e88manl
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. on this,
Port 1 ' Kqlllly lIec(]r<lll1~ Dlllco
,,,It.,, .,t Ii L! !til' ";ll;d"~ ul r~o'lro 01 fedfHollallliun
Form 668 (V) (Rov, 10.93)
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Form 668 (Z) " Doperlmonl 01 Ih. Tr...ury . Inlornol nevenu. Servlel
IA.. 6.141 Certificate of Release of Federal Tax Lien
Dlltrlet So,lel Numbor for Un bv n.c.rdlna 0111..
Il,j, 11.111 , , ;" I " . ~ l ,
I elrtlly Ihll II to Ihl lollowlnu.neml I..peyer, Ihl roqulremenll 01 leellon 6325 (e)
ollhl Internll Rlv.nul Cadi h.vI blon ..lIlnld lor Ihe I.... 1I11.d b.low .nd lor
In .1.lulory .ddlllon.. Th.llloll, Ihl lI.n provld.d by Cod. ..ellon 6321 lor Ih...
t.... .nd .ddlllon. h.. b..n rel....d, Thl proper ollleer In Ih. ollie. where thl .
,
no lice 01 Inlornel r.vonuo lax lien WPl lIIod on ..___._~~_-'-_ .,
,,' (,I'
10 ~ Ie In aulhorlzod 10 nolo Ih. books 10 .how Ih. r.I.... 01 Ihl. lI.n for -
Ih... lax.. ond eddlllonl
N.ml 01 TuplyeI1t<l. I;': I I v..'
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IIH.lI'n :;11 : ',PII'-II, IN: 'IIi"'I' 1 11"'1, \- ,. Ii ~,;},~",':J
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1./) II'" ,I II/tf . I! ,'" : ~; . I.i". . t. I \i,1 ';).'1 ~~;:\
Tox Period Dole 01 Losl Doy lor Unpaid eelanee
Kind 01 Tox Ended Idenlllylng Number Assessmenl Aellllng 01 A..enmenl
(a) (b) (e) (d) (e) (I)
':/'lJ f)I',/ ~n/t;I':;'1 '""'11 ,'I J I, / ... ,;"1/ ',i'-l (JUl. '.!,..",! . :lll) I . 'f J.:
',loll 1,)':1/ :1)/';'.>: , : . ! . ~ ! '! J J 1\ i l ;"'.1/ ';1,~ CiG..... .1/( .J I.t(. ,',',. t't,
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Pineo 01 Filing
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Thts nUllet; W.1S pwpilwd and SIOIWU al _
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INGlE C.,M'CBlfI 01 ol/;t."i.t/,or,'fld lit iJ~ III ',Ihe .1rh"l'>t1t"',/fl'I"'f! f' "0/ flUen/,,' to ,he Ioo1!,{1,;)' ill flt/P,r,", 0' nelelllfl tI' 'rd",1 r,. II,,, R'II Rul "..,ea, "".,
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PAnT I. nECOIIOltlO OFFICE 'o,mllllIIIAn6-e41
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