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1-,.\ Oepertment of the Trllsury . Internel Revenue Service
rm 668 (V) (c)
v, October 1993) Notice of Federal Tax Lien
strict Serial Number For Opl/onal Usa by Racordlng Olllca
1'1 I I ,1' j ~ i r' i I I .. . '-'I. ' ,
,
As provided by sections 6321, 6322, and 6323 of the Internal Revenue -li(e L~~\-33
f .) ,
Code, we are giving a notice that taxes (Including Interest and penalties)
have been elsessed against the followlng.named taxpayer. We have made FTl
a demand feor payment of this liability, but It remains unpaid. Therefore,
there Is a lien In favor of the United States on all property and rights to
property belJnglng to this taxpayer for the amount 01 these taxes, and c/>
additional penalties, Interest, and costs that may accrue. ...
""
Name of Taxpayer DIII.1j1 j]', ....."
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Residence , ul,:; j=.1.J ' T C
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. -. ~
unless notice of lien Is reliled by the date given in column (e). this notice shall, ,\,-,' L"-J ,e
on the day lollowing such dat'3, operate as a certificate of release as defined
in IRC 6325(a). (\....ti<~~c;.Sl K" do'1+1'1
Tax Period Date 01 Last Day for Unpaid Balsnc.
Kind 01 Tax Ended Identifying Number Assessment Rellllng of Assessment
(a) (b) (e) (d) (e) (f)
" '. ' . "-
Place 01 Filing
, , ','" II " Total $
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This notice was prepared and signed at
. on this,
the '1 ~'~;;." ...d...... '.0 ,"'9_ ~
. . t:. "1"/
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I Tille
(NOTE: c"tltle". 01 Ometf luttlorlud b)' law 10 takl .ckno.....I.C:wm.nts 1'1 not e"entlal to "'1 v'lidI1)' of N01lCt of Fed,ral rl. lien
Rev Rut 71,466, 1971 .2 C B 409)
Part' . Kept By Recording Office
Form 1188 (Y)(e) (Rev 10 93 \