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Dlplrlmlnl of Ihl Trl..ury . Internal Rlvlnul Service
orm 668 (Y) (c) Notice of Federal Tax LIen
~ev, October 1993)
Jlstrlct Serial Number FOI Opl/onll U'I by "ICOldlng OI/lCl
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As provided by .ecUons 6321, 6322, and 6323 of Iha Internal Revenue
Code, we are giving a noUce Ihal laxe. (including Intereet and ponaltle.)
hava been assessed agaln.t Iha lollowlng,namod laxpayer. w. have made
a demand lor payment 01 Ihls liability, but II remain. unpaid, Thertllore,
there Is a lien In favor 01 Ihe United Stales on all property and right. 10
proparly belonging to Ihl. taxpayer lor Ihe amount of the.e laxe., and
addltlonsl penalties, Interest, and costs that may accrue,
~ame of Taxpayer
lesidence
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IMPORTANT RELEASE INFORMATION: For each assessment hsted below, l..,);' ('I' If: !::J.]'/)
unless notice of lien Is refiled by the date given in column (e), this notice shall, /:..11.,+- ..)$' .s:,,){)
on the day following such date, operate as a cer1lficate 01 release as delined 9.m p~t.
In IRC,6325(a),
Tax Period Dale of Lsst Day for Unpaid Balanc.
Kind olTax Ended Identifying Number Assessment ReWlng of A.....ment
(8) (b) (c) (d) (0) (f)
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'lace of Filing . ,
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'his notice was pro pared and signed at
, on Ihls.
1e
; day of
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:tgnalure- .,.
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AAflca"~Oltlc" 1uU'l~~I~""btri).. t9"II\l.1 .ckno~htdgmlnl' I, nol ....nIl8110 thl ~'lidlty ot Nolle. 01 F,d.,al Tax lI.n I
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I _, -' ... Part 1 . Kept By Recording Office Form 668 (V) (c) (Rev, 10/93) .:
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