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Form 668 (2) "i, Doportmont ollho TrooDury -Intornal Rovonuo Sorvlco
(nev, 6-9') Certificate of Release of Federal Tax Lien
Dlstrlcl Sorlol !lumbor For U.. by Rlcordlng OlllcI
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I certlly Ihol os to Iho 101l0wlng.nomJ loxpoyor. tho roqulromonls of soctlon 6325 (0)
01 tho Inlornol Rovonuo Co do hovo boon sotlsflod for Ihe loxos IIsled bolow end lor
011 slolUlory eddlllons. Thorelore. Iho lion provldod by Co do soctlon 6321 lor those
taxes end eddltlons has boon roloesod, Tho propor officor In tho offlco whoro Iho <', I.I.)
no\lc~ollnlernal rovonue lox lion was 1II0d on n
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19 ~ Is In authorlzod to nolo Iho books 10 show tho roloo,e of Ihls lion lor , -:1':
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Iheso Inxes ond oddltlons ~, " r'-! ,j :n
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Nama 01 Taxpoyor" -
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Tax Porlod 001001 Lasl Day lor Unpaid Dolance
Kind of Tnx Endcd Idcnlllylno Numbcr Asscssmenl noWlng 01 Auoumonl
(n) (b) (e) (d) (o) (I)
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Placo of Filing
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PAflT 1 . 'l[COI1U,,1O orlle[
FOIm en (Z) IR", ~g.)
CAT. NO eoc281
Department ollhe Treasury -Internsl Revenue Servte.
arm 668 (V) (c) o' -.,
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ev, October 1993) Notice of Federal Tax Lien
Istrlct Serial Number For Option.' U,. by RecordlnQ Ollie.
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As provIded by sections 6321, 8322, and 6323 01 tho Internal Rovenue
Code, we are giving a notice that texos (Including Inlorosl and ponaltles) FTL
have been assessed against the followlng-namod taxpayer. We hove mado " '!.::.too
a demand for payment 01 this tlabllllY, but It remains unpaid. Thorelore, .;) :, c::
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there Is a lien In favor of the Unltod Stetes on 011 properly and rig his to : -, ...~
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property belonging to this taxpayer for the amount of Ihese taxos, and ,
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addltlonel penaltles,lnlerest, and costs that may accruo. ' ' w
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tame 01 Taxpayer 1~IILl ] :~~I I~,_~"II:'I ~. .-4.. -" 0
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[, '.' h I "r-hl:..., - I- =
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reSidence ~-< c.o
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IMPORTANT RELEASE INFORMATION: For each assessmontllstod below. IA W f\J
unless notice of lien Is reWed by Ihe date given In column (e). Ihls notice shall.
on the day following such dale. operate os a certificate 01 release as dellned Cud ~,'J.:1'1~
In IRC 6325(0). ,:.~ ';) cO 11-
Tax Period Oatoof Last Day lor Unpaid Balance
Kind ofTax Ended Idenlllylng Number Assessment RoWing 01 Assessment .
(a) (b) (e) (d) (0) (f)
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rlace of Filing
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his notice was prepared and signed al
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Ie 1:1 I, day 01 III I ..
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2 C,O. 409 J~i;,"
, ., Pori 1 - Kept By Rocordlng Ollleo Form 668 (V) (c) (Rov. 10/93)
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