HomeMy WebLinkAbout95-04683
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Deportment 01 tho Troolury. Intornol Rovonue Service
torm 66B (V) (c) , ,
Rev. October 1993) Notice of Federal Tax Lien
~Islrlct Serial Number For Opl/onel UfO by Recording Olllce
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue
Code, wa ara giving a nollce that taxes (Including Interest and penolllos) rfL
have boen assessed against tho followlng.nomed taxpayer. We have made I"" :::.-
a domand for payment 01 this liability, but It remains unpaid. Therefore, c:::
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there Is a lien In favor of the United States on 011 property and rights to ......
! property belonging to this taxpayer for the amount of these taxes, and . -
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, addlllonal ponallles, Interest, and costs that may accrue. ,
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~ame of Taxpayer , . , ;;:~.:;~~ ,If:'
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~esldence :J:=-t .
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I IMPORTANT RELEASE INFORMATION: For each assessment listed below. f1q.c.'O~
unless notice of lien Is refiled by the date given In column (e). this notice shall.
on the day (ollowlng such date, operate as a certificate of release as dellned LL. H 'i:..s.J:!
In IRC 6325(a). "'.. :J.q~Sq
Tax Period Date 01 Last Day for Unpaid Balance
Kind ofTax Ended Identifying Number Assessment ReWlng of Assessment
(a) (b) (c) (d) (0) (f) ,
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llace of FIling
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'hls notice was prepared and signed at
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" :, day of
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I all/c\, .U/ha,lz blTiil\., 'Po lake .cknowledgrnanl'ls nal ....nll.lla Iha vallditV al Nollc. al F.d.,.1 Tu lI.n
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~1A.o ' I Pori 1 . Kept By Recording Offlco Form 66B (V) (0) (Rev. 10/93)
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