HomeMy WebLinkAbout95-05031
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Dlpartmlnt 01 thl Trl"ury . Intimal Rlvlnul Slrvlel
orm 668 (V) (c)
flev, October 1993) Notice of Federal Tax Lien
bistrict Serial Number Fa, Opl/onl' Usa by Recording OlllcI
, '
I As provided by Bectlonl 6321, 6322, and 6323 of the Internal Revenue tl (/S- 5031
Code, we are giving a notice that taxes (Including Interest and penalties)
have b.en assess.d against the followlng.named taxpayer. W. have made C:TL
I demand for paym.nt of thll IIlblllty, but It r.malns unpaid. Tharefore,
thar. II I lI.n In flvor of th. Unlt.d Stlt.. on all properly and rights to
properly belonging to this taxply.r for thl amount of these taxes, and
additional penlltl.., Int.r.st, Ind costs that may accrue. L.,..:
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Name of Taxpayer {'-.J
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Residence r,~
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. -
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unless notice of lien is rellled by the date given In column (e), thiS notice shall. .,. 'f tAJI.......
on ths day following such date. operate as a certificate 01 release as defmed ll\ tI (! )'-.I'~ I
. In IRC 6325(a), .' " :iT1,!?
Tax Period Date of Last Day for Unpaid Balanc.
Kind of Tax End.d Id.ntlfylng Numb.r Au.ssmant Reflllng of Assessm.nt
(a) (b) (e) (d) (e) (f)
Place of FIling
Total S
This notice was prepared and signed at
,on this.
the day of .19_,
'.......-r '7 L,_ _ -.'" ....
Signature ... .~ ~. .~:
~
Tille
't author ud by law to I~k. ICkl"lcwled.m'1'11S 11 not tnenl:11 10 1h, validitv Of NoU" of Fld"., Tax Illn
409)
Part 1 . Kept By Recording Office
Form &e8 (V) (c) (Rev, 10193) .
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