HomeMy WebLinkAbout95-05400
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:;:'1 Deplrtment of the Trl"ury . Internll Revenue Service
iForm eea (V) (0)
! (Rev. October 1993) Notice of Federal Tax Lien
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i For apI/on.' u.. by R.cordlng O/llc.
\ District Serial Number
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\ r't. j Ii .jl' I I t, I d . t ;\ 11(1 r ,')tlco r-TL
I A. provld.d by ..ctlon. 6321, 6322, end 6323 of the Internal Revenue .) ,
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I Cod., w. .r. giving. notlc. that texe. (Including Interest and penalties)
h.v. been .......d .galn.t the followlng.named taxpayer. We have mode
. d.m.nd for p.ym.nt of thl. liability, but It remains unpaid. Tharefore, ,'~,
th.r. I. . lI.n In f.vor of th. Unlt.d Statll on 011 property and rights to "
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prop.rty b.longlng to thl. t.xpay.r for the emount of these taxee, and ..-
.ddltlon.' p.n.ltllI,lnt.rllt, and COlt. that may accrue.
N.m. of Taxpayer l'l.\h Iii .. 11 !iI ( 1'; I 'I I'll ..:..;.,
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Residence .
t'/,.: 11'1'11 1'''1\..'1 -
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, 'Is'l,W{JrI
unless notice of lien Is reWed by the date given In column (e), this notice shall, l." 1\ &'.~'/] 7
on the day lo~:~Wlng such date, operate as a cerllllcate of release as defined
In IRe 6325 a . "'II ~C''iC, ',1
T.x P.rlod Date of Last Day for Unpsld Bal.ne.
Kind of T.x End.d Identifying Number Assessment Reflllng of A.....m.nt
(a) (b) (e) (d) (e) (I)
Jt).1'-j I , , . , . l." .1
ll,i--lt", ! I " I I I " ':;1,(')
l;-l.-tU " I I . , , r__,. " .', (,:,..'11,'
1,",11 , . I t , , 'II . ' ..:.
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, Place of Filing
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This notice was prepared and signed at
, on this,
tho 'i' day 01
, to...,...
, ',19_,
,"'..", '~'l"r"''''''
"Ignature
Title
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to take Dcknowledgmenlll1 not ,,,8nllallo tho vpUdllV ot NotlcI 01 Fldll.1 Tax III"
Form 668 (VI (0) (Rev. 10/93)
Pert 1 - Kapl By Recording Olllca
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Form 666(Z) '1 'J ~ Dep.rlm.nl ollh. Tr...ury . Inl.rn.1 R.v.nu. S.rvlc.
[RIYS'871 Certificate of Release of Federal Tax Lien
DI.trlct Serl.1 Numb.r For U.. bv Recordlno Offlc.
I.lHjNPVI_VAN I A :""'J':.tl.:.: t "q,~,q
I c.rtlfy th.tth. followlng.n.m.d t..p.y.r. und.r th. r.qulrem.nt. of ..cllon 8325 (.)
01 th. Int.rn.1 R.v.nu. Cod. h.. ..1I.II.d th. t.... 1I.I.d below .nd .11 .t.tulory
.ddltlon.. Th.refore, th. lI.n provld.d by Cod. ..ctlon 8321 lor th... I.... .nd ,
.ddltlon. h.. been rel....d. Th. proper offlc.r In th. o"lc. where th. nolle. 01 ,
Int.rn.1 rev.nu. tax lI.n w.. iliad on II('t.o"fJl" II , . .
1 9~lb, I. .uthorlz.d to not. th. bookltt' .how Ih. r.I.... 01 thl. lI.n for , ,
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th... t.... .nd .ddltlon., ' ,
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N.m. 01 T..p.y.r ,
I'I/IRIU A /I. lil.llR I ii, N DEf<lI:3 ,
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R..ld.nc. ". .
\ '~'f:l f EN I IIIl I Iii': 1,1 ..
C/II-11' H II. L . I'A t71l11-S~':'H
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COURT HECllR [II NCi I NFnR~IA1I nt.l: c,-\.. ,\ \4'd\.i.53
L 1 "P." PB-Jt? uec No). '.:"~ r 1 ~ I N...
n/~ nlll n/ft 95 -FAr.. lfl I Atl ..., Olt '2'i1
Kind ofT.. Tax Period End.d Id.nllfylng Number D.t.of L..t D.V for Unpeld ,.I.nce or
A.....m.nt A.llllng A.....llIInt
(a) (b) (c) (d) (a) (f)
1041.1 t2/311 1987 ()';l3-70-'1 24 1 I-IE./II;' '1908 "u 1'11/1 '~':'l() 761.'::l4
1040 12/3J/J989 '1'l:-]-7lJ-J;;'4J 1 n/~\811. ~'.:' 1 1 J I '271 ,'00 J 35J .01
104(1 12/311 1 9~h I '.,.:13-7....,.t;;'lll nt',-;'4.1 1'39',.~ 1(1/ iJi / 21I(1't." 220a.40
Ifl4Cl 1.'/3J 1 J ~j~'l 0'3:..-.111- J 1_-'4 J or,.1 I){J " J ';l~.&:? n7 in8It'(II"L' 667.38
1040 1.'/3[/1'019.' (t'.~lJ-l( 1--1 ~?41 tn, I l' 1 ~1',~'3 11/ t (1/ ,.:(tr)~-3 4670.61
Iddr*it". ~..Io.*.*."I-"~ 1-..,........ ........... .,.......... ................
PI.c. 01 Filing
lIt' nt Illln Id ;d ~' Tol.1 .
C 11I1I1'Pr ldtl.1 ( I!lllll , 13,;4'<.'34
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This notice was prepared and signed at _____Ll.LL~L.llL.;.jb----l.:1~___
, on this,
the 1 41 I, day OI._l\ll:Ju~L_ . __.-L:L.;JJ
Slgnaturo
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I Tillo
'1,1111.
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(NOl E C,r!ificale u' llff/eM ,wfllOll/9l11lY I,ll" 11' ',1.\" arllnM'VI'OIHVIlI. " no' r.UfttrlmJ to 1110 \'dIIlMt, "' CpII/flt-'al" llf ne/piU' 01 FtltUlr.J r.. lien Re\! Rill ".48tJ, r81"2 ca. 400)
PART I ' RECOROINO OFFICE
Forni ... (Z) (nev. 8.U71
CAT, NO S002S1
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