HomeMy WebLinkAbout95-03213
Form 668 (V)
(Rlv O'\l1IJll' 'lJtJll
,Olstrlct
Resldenco
Kind 01 TI.
(a)
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Place of Filing
OOl',,"monl ollho J,ou.ury' InlolllOl flovonuo SOIvlco
Notice of Federal Tax Lien
SOflal NUl1llHIf
Identifying Number
(e)
i I. I, 1'1
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AI provided by sections 6321, 6322, end 6323 of the Intolnol Revonuo
Code, we ere giving e notice that 'oxos (Including Inlerost and ponoltlos)
heve been enessed egalns' tho following-named tnxpayer. Wo hovo mnde
I dlmand for payment of this lIablllly, but It remains unpaid. Therelore,
Ihlre II 0 lien In favor 01 the United Slates on 011 properly and rights to
proplrty belonging 10 Ihls tupayer lor the amount 01 these loxes, Ilnd
Iddltlonal penalties, Interast, and costs Ihet may accrue,
Name 01 Taxpayer
IMPORTANT RELEASE INFORMATION: For oacll ossossll1onll,stod uolow,
unless notice 01 lien Is reliled by the dale given In column (0), 11115 notice slmll,
on the day following such dale, oporate as 0 corlll'calo of rolooso as dohned
In IRC 6325 a .
TI. Period
Ended
(b)
This notice was prepared and signed at
the dayal'
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Signature I. -;".t:' (. (,
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Dale 01
Assessment
(d)
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101m 668 (V) (nllv 1003)
Port 1 ' Kepi Ily IlI'CoHtlng Ofllce
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